Michigan Care Improvement Registry HL7 2.5.1 Specification Guide for Query by Parameter (QBP) Version 1.5 JUNE 7, 2016
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Michigan Care Improvement Registry HL7 2.5.1 Specification Guide for Query by Parameter (QBP)
Version 1.5
JUNE 7, 2016
Document Description
This guide is intended for immunization providers and their vendors to assist in
connecting to the Michigan Care Improvement Registry (MCIR). MCIR is an
immunization registry that compiles complete immunization histories for children and
adults in Michigan. This document explains the technical details of how to Query MCIR
for a patient records and receive the immunization history and forecast for next dose
due for that patient.
Message types supported:
QBP Z44^CDC
RSP Z42^CDC
ACK
Message formats supported:
HL7 2.5.1 version 1.5
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Revision history
Revision Date Author
Release 1.0 August 1, 2013 Therese Hoyle
Release 1.1 January 7,2014 Therese Hoyle
Release 1.5 June 7, 2016 Sallie Sims
A list of changes may be found at the end of Implementation Guide
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Michigan Care Improvement Registry
Introduction and History MCIR was created in 1998 to collect reliable immunization information and make it accessible to
authorized users online. In 2006, MCIR was expanded to include adults. By state law, providers
are required to submit childhood immunizations within 72 hours of administration. In addition,
providers are allowed and highly encouraged to report adult vaccinations.
MCIR benefits health care organizations, schools, licensed childcare programs, and Michigan’s
citizens by consolidating immunization information from multiple providers. This reduces
vaccine-preventable diseases, over-vaccination, and allows providers to see up-to-date patient
immunization history. MCIR also has the ability to assist with pandemic flu preparedness
and can track vaccines and medications during a public health emergency.
Health Level Seven (HL7)
History HL7 was first formed as a standard in the late 1980’s as a collaboration between vendors of
health systems and hospitals. The goal was to create a standard message format that disparate
systems could use to exchange health data. The name of HL7 was settled on because HL7 was
originally conceived to define message structures in the seventh level of the ideal model of
networks. At that time, the Internet was not widespread and there was quite a lot of variation in
hospital networks. It was decided that HL7 would only define messages and not how these
messages were sent. Within a year HL7 version 2 was released. This version has been in use for
over 20 years. MCIR is currently using HL7 Version 2.5.1 messages.
Message Specifications There are three controlling documents that define how the MCIR interface works. They are
arranged in a hierarchy of documents, each refining and constraining the standard:
The first is the HL7 2.5.1 standard, which was developed by Health Level Seven, a not-for-profit
ANSI-accredited standards developing organization. This standard defines the structure and
content of immunization messages but leaves many specific implementation details undecided.
The second document is the CDC’s Implementation Guide for Immunization Messaging. This
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guide gives specific instructions regarding how to report to immunization registries, but still
leaves some implementation decisions to each state registry. This guide, and other technical
information can be found at this CDC website:
https://www.cdc.gov/vaccines/programs/iis/technical-guidance/downloads/hl7guide-1-4-2012-
08.pdf
What you are reading now is the third document. It finalizes all implementation decisions and
defines exactly what MCIR will and will not accept. It is written in accordance with the standards
set in the first two documents. Each of these standards should be consulted when developing an
interface with MCIR.
How to Send Data MCIR requires connectivity through a Qualified Organization/Sub-State Health Information
Exchange. Click on this link for a list of Qualified Organizations: http://mihin.org/exchanges/
Please contact the MCIR Help Desk 1-888-243-6652 option 3 or via E-mail
[email protected] for questions HL7 messaging.
NOTE: Required MSH-11 modifications effective January 2014 for MCIR QBP Onboarding
Pre-Production Onboarding
Prior to entering into full productions submitters are required to go through a data/message
quality phase for Pre-Production Onboarding. During this phase real messages are sent, just as
in production, but MSH-11 “Processing ID” to be set to the literal value of “T”. Messages are
reviewed for completeness and quality by MCIR staff. Only after correcting any quality issues
with the message, are submitters allowed to enter full production
Production
Once a submitter has completed Pre-Production Onboarding and received the approval to enter
into production from MCIR staff, they must change MSH-11 “Processing ID” to be set to the
literal value of “P”. Submitters are advised to include this requirement in any internal project
scope or contract with an external organization conducting the configuration of the MCIR
interface.
Testing After Entering into Production
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If for any reason a submitter wishes to test messages after entering into production (e.g., during
an EHR upgrade) they may use the Initial Test site at any time. If additional testing is required,
they may also request an additional round of Pre-Production Onboarding testing. This must be
coordinated with MCIR staff and the MSH-11 “Processing ID” must be set to the literal value of
“T” for any test message. Production messaging can continue during additional rounds of Pre-
Production Onboarding testing as long as the MSH-11 “Processing ID” is set to the literal value of
“P” for production messages and MCIR staff have approved
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Version 1.5 .................................................................................................................................. 1 Document Description ...................................................................................................................... 2 Message types supported: ............................................................................................................... 2 Message formats supported: .......................................................................................................... 2
HL7 2.51 ............................................................................................................................................................. 2
Health Level Seven (HL7) ....................................................................................................... 2
Chapter 1—Messages and Messaging Infrastructure .................................................. 9 Introduction ............................................................................................................................................ 9 HL7 Messaging Infrastructure .............................................................................................................. 9 HL7 definitions ........................................................................................................................................ 9 Basic Message Construction Rules ................................................................................................... 11
Encoding Rules for Sending .................................................................................................................... 11 Encoding Rules for Receiving ................................................................................................................. 11 Implications of the Encoding Rules ..................................................................................................... 11 Determining Usage of Segments, Fields and Components ......................................................... 12
Message Attributes Common to All Messages .............................................................................. 17 Segment Attributes Common to All Segments .............................................................................. 18 Acknowledging a Message—ACK ..................................................................................................... 19
Request Immunization History Query Profile –Z44^CDCPHINVS .......................................... 20 Query Grammar................................................................................................................................ 21 Response Grammar......................................................................................................................... 21 Return an Immunization History – Z42^CDCPHINVS .................................................................... 21
Introduction: ................................................................................................................................................. 21 Static Definition ........................................................................................................................................... 22
Response Grammar RSP^K11 Constrained by This Profile ............................................. 22 Response Grammar RSP^K11 ..................................................................................................... 22
Chapter 2---QBP and RSP Storyboard .............................................................................. 23 QBP and Response Messages (RSP and ACK) ......................................................................... 24
QBP – Query for Patient ............................................................................................................................ 24 RSP – Single Match Found, No Errors ................................................................................................. 24
Invalid Shots .................................................................................................................................. 25 Immunization Recommendations ......................................................................................... 25 RSP – No Match Found, No Errors .............................................................................................. 26 Storyboard ......................................................................................................................................... 26 QBP and RSP – Patient Deceased, No Errors .......................................................................... 27 QBP and RSP – Patient Opted Out of MCIR, No Errors ........................................................ 27
Chapter 3 Segments and Fields ......................................................................................... 29 ORC—Order Request Segment ......................................................................................................... 33
ORC field definitions .................................................................................................................................. 35 PID—Patient Identifier Segment ...................................................................................................... 37
PID field definitions .................................................................................................................................... 39 QAK—Query Acknowledgement Segment ..................................................................................... 42
QAK field definitions .................................................................................................................................. 42 QPD Input Parameter Specification (Z44) ....................................................................................... 42 QPD Input Parameter Field Description and Commentary .............................................. 44 RCP Response Control Parameter Field Description and Commentary .................................... 46
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RXA—Pharmacy/Treatment Administration Segment ................................................................ 46 RXA field definitions .................................................................................................................................. 49
Chapter 4—Data Types and Value Sets .......................................................................... 52 Data Types for IIS Use ......................................................................................................................... 52
CE—Coded Element (most uses) .......................................................................................................... 53 CQ—Composite Quantity with Units ................................................................................................... 55 CWE—Coded With Exceptions .............................................................................................................. 56 CX—Extended Composite ID With Check Digit .............................................................................. 57 DT—Date ........................................................................................................................................................ 58 DTM—Date/Time ....................................................................................................................................... 59 EI—Entity Identifier .................................................................................................................................. 60
Maximum Length: 427 ...................................................................................................................... 60 ERL—Error Location ................................................................................................................................. 61
Maximum Length: 18 ......................................................................................................................... 61 FN—Family Name ....................................................................................................................................... 62 HD—Hierarchic Designator .................................................................................................................... 62 ID—Coded Values for HL7 Tables ........................................................................................................ 64 IS—Coded Values for User Defined Tables....................................................................................... 64
Maximum Length: 20 ......................................................................................................................... 64 LA2 -- Location with Address Variation 2 ......................................................................................... 65
Maximum Length: 790 ...................................................................................................................... 65 MSG—Message Type.................................................................................................................................. 66
Maximum Length: 15. ........................................................................................................................ 66 NM—Numeric ............................................................................................................................................... 66
Maximum Length: 16 ......................................................................................................................... 67 PT—Processing Type ................................................................................................................................ 67
Maximum Length: 3............................................................................................................................ 67 SAD—Street Address ................................................................................................................................. 67
Maximum Length: 184 ...................................................................................................................... 68 Note: Appears ONLY in the XAD data type ........................................................................... 68
SI—Sequence Id ........................................................................................................................................... 68 Maximum Length: 4. This allows for a number between 0 and 9999 to be specified. 68
TS—Time Stamp .......................................................................................................................................... 68 Maximum Length: 26 ......................................................................................................................... 68
VID—Version Id ........................................................................................................................................... 68 Maximum Length: 973 ...................................................................................................................... 69
XAD—Extended Address ......................................................................................................................... 69 Maximum Length: 631 ...................................................................................................................... 70
XCN - Extended Composite ID Number and Name for Persons ............................................... 71 Maximum Length: 3002 .................................................................................................................... 72
Extended Person Name (XPN) ............................................................................................................... 74 Maximum Length: 1103 .................................................................................................................... 75
XTN - Extended Telecommunication Number ................................................................................ 76 Maximum Length: 850 ...................................................................................................................... 77
Chapter 5—Code Tables ...................................................................................................... 78 User-defined Table 0001 - Sex .......................................................................................................... 78 HL7-defined Table 0003 - Event type ............................................................................................... 78 User-defined Table 0004 - Patient class .......................................................................................... 79
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User-defined Table 0005 – Race ....................................................................................................... 79 HL7-defined Table 0008 - Acknowledgment code ........................................................................ 80 User-defined Table 0010 - Physician ID ........................................................................................... 80 HL7-defined Table 0061 - Check digit scheme ............................................................................... 80 User-defined Table 0063 – Relationship ......................................................................................... 80 User-defined Table 0064 - Financial class ....................................................................................... 81 HL7-defined Table 0076 - Message type ......................................................................................... 82 HL7-defined Table 0078 - Abnormal flags ....................................................................................... 83 HL7-defined Table 0085 - Observation result status codes interpretation .............................. 83 HL7-defined Table 0091 - Query priority ........................................................................................ 83 HL7-defined Table 0102 - Delayed acknowledgment type .......................................................... 83 HL7-defined Table 0103 - Processing ID .......................................................................................... 83 HL7-defined Table 0104 - Version ID ............................................................................................... 83 HL7-defined Table 0105 - Source of comment ............................................................................... 84 HL7-defined Table 0119 – Order Control Codes ............................................................................ 84 HL7-defined Table 0126 - Quantity limited request ..................................................................... 84 HL7-defined Table 0136 - Yes/No indicator ................................................................................... 84 HL7-defined Table 0155 - Accept/Application acknowledgment conditions ........................... 85 HL7-defined Table 0162 - Route of administration ....................................................................... 85 Example ............................................................................................................................................... 85 User-defined Table 0189 - Ethnic Group ......................................................................................... 86 HL7-defined Table 0190 - Address type .......................................................................................... 86 HL7-defined Table 0202 - Telecommunication equipment type ................................................ 87 User-defined Table 0203 - Identifier type ...................................................................................... 88 User-defined Table 0204 - Organizational name type .................................................................. 95 HL7-defined Table 0207 - Processing mode ................................................................................... 95 User-defined Table 0208 - Query response status ........................................................................ 95 HL7-defined Table 0211 - Alternate character sets....................................................................... 95 User-defined Table 0215 - Publicity code ....................................................................................... 96 User-defined Table 0220 - Living arrangement ............................................................................. 96 HL7-defined Table 0227 - Manufacturers of vaccines (code = MVX) ......................................... 96 User-defined Table 0288 - Census tract .......................................................................................... 98 User-defined Table 0289 - County/parish ...................................................................................... 99 HL7-defined Table 0292 - Codes for Vaccines administered (code=CVX) ............................... 100 User-defined Table 0296 - Language ............................................................................................. 116 User-defined Table 0297 - CN ID source ....................................................................................... 117 User-defined Table 0300 - Namespace ID .................................................................................... 117 HL7-defined Table 0301 - Universal ID type ................................................................................. 117 HL7-defined Table 0322 - Completion status ............................................................................... 117 HL7-defined Table 0323 - Action code........................................................................................... 118 HL7-defined Table 0356 - Alternate character set handling scheme ....................................... 118 HL7-defined Table 0357 - Message error status codes .............................................................. 118 User-defined Table 0360 – Degree ................................................................................................. 119 User-defined Table 0361 – Application ......................................................................................... 120 User-defined Table 0362 – Facility ................................................................................................. 120 User-defined Table 0363 – Assigning Authority .......................................................................... 120 User-defined Table 0396 – Coding system ................................................................................... 122 User-defined Table 0441 - Immunization registry status .......................................................... 123
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User-defined Table 0471 – Query Name ....................................................................................... 123 HL7 Table 0516 - Error Severity (use in ERR-4) ........................................................................... 123 User-defined Table 0533 – Application Error Code..................................................................... 124 CDC-defined NIP001 - Immunization information source ......................................................... 124 CDC-defined NIP002 - Substance refusal reason ......................................................................... 124 CDC-defined NIP003 - Observation identifiers ............................................................................ 125 CDC-defined NIP004 - Contraindications, Precautions, and Immunities ................................ 127 Value Set Name – Vaccination Contraindications ....................................................................... 128 Used in OBX- 5 ................................................................................................................................. 128 Value Set OID - 2.16.840.1.114222.4.11.3288 ..................................................................... 128 Value Set Code:: PHVS_VaccinationContraindication_IIS ................................................ 128 Value set definition: indicates a contraindication to vaccination. ............................... 128 Code Set OID: ................................................................................................................................... 128
SNOMED: 2.16.840.1.113883.6.96 .................................................................................................... 128 CDCPHINVS: 2.16.840.1.114222.4.5.274 ...................................................................................... 128
Value Set Name – Vaccination Reaction - IIS ............................................................................... 130 Value Set OID - 2.16.840.1.114222.4.11.3289 ..................................................................... 130 Value Set Code:: PHVS_VaccinationReaction_IIS ................................................................. 130 Code Set OID: ................................................................................................................................... 131
SNOMED: 2.16.840.1.113883.6.96 .................................................................................................... 131 CDCPHINVS: 2.16.840.1.114222.4.5.274 ...................................................................................... 131
Examples:.......................................................................................................................................... 131 Value Set Name – Vaccination Special Indications - IIS ............................................................. 131 Value Set OID - 2.16.840.1.114222.4.11.3290 ..................................................................... 132 Value Set Code:: PHVS_VaccinationSpecialIndications_IIS ............................................. 132 Code Set OID: ................................................................................................................................... 132
CDCPHINVS: 2.16.840.1.114222.4.5.274 ...................................................................................... 132 Example:............................................................................................................................................ 132 Value Set Name – Immunization Profile Identifiers - IIS ............................................................ 132 Value Set OID - 2.16.840.1.114222.4.11.3291 ..................................................................... 132 Value Set Code:: PHVS_ImmunizationProfileIdentifier_IIS ............................................. 132 Value set definition: Identifies the profile used by the message. ................................. 132 Code Set OID: ................................................................................................................................... 132
CDCPHINVS: 2.16.840.1.114222.4.5.274 ...................................................................................... 132 Example:............................................................................................................................................ 133 Value Set Name – Immunization Schedule Identifiers - IIS ....................................................... 133 Value Set OID - 2.16.840.1.114222.4.11.3292 ..................................................................... 133 Value Set Code:: PHVS_ImmunizationScheduleIdentifier_IIS ........................................ 133 Value set definition: Identifies the schedule used for immunization evaluation and forecast. ............................................................................................................................................. 133 Code Set OID: ................................................................................................................................... 133
CDCPHINVS: 2.16.840.1.114222.4.5.274 ...................................................................................... 133 Example:............................................................................................................................................ 133 The 99xxx is the local code table identifier. xxx are alpha characters...................... 133 Value Set Name – Evidence of Immunity - IIS .............................................................................. 133 Value Set OID - 2.16.840.1.114222.4.11.3293 ..................................................................... 134 Value Set Code:: PHVS_EvidenceOfImmunity_IIS ............................................................... 134 Code Set OID: ................................................................................................................................... 134
QBP Guide Version History Changes ............................................................................. 135
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Chapter 1—Messages and Messaging Infrastructure
Introduction
This chapter describes each of the messages used to accomplish the use cases described in previous chapters. These messages are built from the segments described in Chapter 3, Segments and Message Details. The Segments are built using the Data Types specified in Chapter 4. Readers are referred to these chapters for specifics on these components. Issues related to segments and fields, which are message specific, will be addressed in this chapter.
HL7 Messaging Infrastructure
This section will contain a basic description of the terms and definitions, which are used in this document in order to understand the Health Level 7 standard as it applies to immunization information systems. More detail may be found in the HL7 2.5.1 standard in Chapters 1, 2 and 2A.
HL7 definitions
The terms below are organized to move from the message to subsequently more granular components.
Message: A message is the entire unit of data transferred between systems in a single transmission. It is a series of segments in a sequence defined by the message specifications. These specifications are based on constraints to the HL7 specifications, as described in an Implementation Guide.
Segment: A segment is a logical grouping of data fields. Segments within a defined message may be required or optional, may occur only once, or may be allowed to repeat. Each segment is named and is identified by a segment ID, a unique 3-character code.
Example:
PID|||12322^^^Assigning authority^MR^||Savage^Robert^^^^^L^|
This PID segment includes a medical record number and a person’s name.
Field: A field is a string of characters and is of a specific data type. Each field is identified by the segment it is in and its position within the segment; e.g., PID-5 is the fifth field of the PID segment. A maximum length of the field is stated as normative information. Exceeding the listed length should not be considered an error. A field is bounded by the | character.
Component: A component is one of a logical grouping of items that comprise the contents of a coded or composite field. Within a field having several components, not all components are required to be valued.
Example: RXA-5 administered code is composed of 6 components.
Code 1^text 1^code set 1^alternate code 2^alt text 2^alt code set 2
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Item number: Each field is assigned a unique item number. Fields that are used in more than one segment will retain their unique item number across segments.
Null and empty fields: The null value is transmitted as two double quote marks (“”). A null-valued field differs from an empty field. An empty field should not overwrite previously entered data in the field, while the null value means that any previous value in this field should be overwritten.
Value in Field Meaning
“”
|””|
Nullify the value recorded in the receiving system data base.
<empty field>
||
Make no changes to the record in the receiving data base. The sending system has no information on this field.
Null fields should not be sent in immunization messages. Systems which will send null fields (“”) must specify their use in local implementation guides. Systems which will accept and process null fields, as described above, must specify their use in local implementation guides.
Data type: A data type restricts the contents and format of the data field. Data types are given a 2- or 3-letter code. Some data types are coded or composite types with several components. The applicable data type is listed and defined in each field definition.
Code Sets/Systems: Most data elements will have associated lists of acceptable values in tables supported by a standards organization such as HL7 or CDC. These code sets will include definitions to support common usage.
Delimiters: Delimiter characters are used to separate segments, fields and components in an HL7 message. The delimiter values are given in MSH-2 and used throughout the message. Applications must use agreed upon delimiters to parse the message. Messages used in this Guide shall use the following delimiters:
<CR> = Segment Terminator; | = Field Separator; ^ = Component Separator; & = Sub-Component Separator; ~ = Repetition Separator; \ = Escape Character.
Message syntax: Each message is defined in special notation that lists the segment 3-letter identifiers in the order they will appear in the message. Braces, {}, indicate that one or more of the enclosed group of segments may repeat, and brackets, [ ], indicate that the enclosed group of segments is optional. Note that segments may be nested within the braces and brackets. This will indicate that the nested segments are units within a subgroup of segments. Their Usage is relative to the parent segment in the group.
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Basic Message Construction Rules
Encoding Rules for Sending
1. Encode each segment in the order specified in the abstract message format. 2. Place the Segment ID first in the segment. 3. Precede each data field with the field separator. 4. Encode the data fields in the order and data type specified in the segment definition
table. 5. End each segment with the segment terminator. 6. Components, subcomponents, or repetitions that are not valued at the end of a field
need not be represented by component separators. The data fields below, for example, are equivalent:
|^XXX&YYY&&^| is equal to |^XXX&YYY^|
|ABC^DEF^^| is equal to |ABC^DEF|
7. Components, subcomponents, or repetitions that are not valued, but precede components, subcomponents or repetitions that are valued must be represented by appropriate separators. For example, the following CE data type element has the first triplicate empty and a populated second triplicate:
|^^^ABC^Text^Codesystem|
8. If a field allows repetition (Cardinality maximum > 1), then the length of the field applies to EACH repetition.
Encoding Rules for Receiving
1. If a data segment that is expected is not included, treat it as if all data fields within were not present.
2. If a data segment is included that is not expected, ignore it; this is not an error. 3. If data fields are found at the end of a data segment that are not expected, ignore
them; this is not an error.
Implications of the Encoding Rules
The following table lists the expected outcome implied by the encoding rules above.
Table 0-1 Outcome of Encoding Rule Breaches
Condition Immediate Outcome Secondary Outcome
Required segment not present.
Message rejected. Error message returned to sending system.
Segments not in correct order
Out of sequence segment ignored.
If this segment is required, then message rejected.
Segment not expected Segment is ignored
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Condition Immediate Outcome Secondary Outcome
Non-repeating segment is repeated
Repeated segment is ignored. First segment is processed normally.
Information in the repeated segment is lost to receiving system.
Required segment has required fields that are not present or rejected due to errors
Message is rejected. Error message returned to sending system.
Optional segment has required field that is not present or rejected due to errors.
Segment is ignored Message is not rejected because of this error. Error message returned.
Required field is not present. Segment is ignored/rejected. If segment is required, then message is rejected. If segment is not required, the information in the segment is lost to receiving system.
Required field is rejected due to errors.
Segment is ignored/rejected. If segment is required, then message is rejected. If segment is not required, the information in the segment is lost to receiving system.
Incoming data value is not in the list of expected values for a field that is constrained to a list of values.
Incoming data are treated as empty.
Note that all errors in processing a message should be communicated back to the sending system unless the initiating system has indicated that no response is desired.
Determining Usage of Segments, Fields and Components
Many fields and segments in HL7 are optional. This guide tightens constraints on some fields to support functionality required from meaningful use of immunization data. The following list the rules applied to the decisions used to determine usage in this Guide.
1. Any segment, field, or component that is required by the HL7 Version 2.5.1 Implementation Guide for Immunization Messaging is required.
2. Any field or component that is a required but may be empty by HL7 Version 2.5.1 Implementation Guide for Immunization Messaging is required but may be empty1.
3. Any segment, field, or component that is conditional but may be empty in the HL7 Version 2.5.1 Implementation Guide for Immunization Messaging shall be conditional or conditional but may be empty in this Guide, unless this conflicts with 2 or 3 above.
4. Any field designated as required by MCIR is required (See MCIR usage table below). 5. All other fields will ignored by MCIR systems.
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Table 0-1--Usage Code Interpretations for Fields, Components and Sub-components
Usage Code Interpretation Comment
R Required
A conforming sending application shall populate all “R” elements with a non-empty value. Conforming receiving application shall process or ignore the information conveyed by required elements. A conforming receiving application must not raise an error due to the presence of a required element, but may raise an error due to the absence of a required element.
RE Required but may be empty
The element may be missing from the message, but must be sent by the sending application if there is relevant data. A conforming sending application should be capable of providing all “RE” elements. If the conforming sending application knows the required values for the element, then it must send that element. If the conforming sending application does not know the required values, then that element may be omitted. Receiving applications will be expected to process or ignore data contained in the element, but must be able to successfully process the message if the element is omitted (no error message should be generated because the element is missing).
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Usage Code Interpretation Comment
C Conditional This usage has an associated condition predicate. This predicate is an attribute within the message. If the predicate is satisfied: A conformant sending application must always send the element. A conformant receiving application must process or ignore data in the element. It may raise an error if the element is not present. If the predicate is NOT satisfied: A conformant sending application must NOT send the element. A conformant receiving application must NOT raise an error if the condition predicate is false and the element is not present, though it may raise an error if the element IS present.
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Usage Code Interpretation Comment
CE Conditional but may be empty
This usage has an associated condition predicate. This predicate is an attribute within the message. If the predicate is satisfied: If the conforming sending application knows the required values for the element, then the application must send the element. If the conforming sending application does not know the values required for this element, then the element shall be omitted. The conforming sending application should be capable of knowing the element (when the predicate is true) for all ‘CE’ elements. If the element is present, the conformant receiving application shall process or ignore the values of that element. If the element is not present. The conformant receiving application shall not raise an error due to the presence or absence of the element. If the predicate is not satisfied: The conformant sending application shall not populate the element. The conformant receiving application may raise an application error if the element is present.
O Optional This element may be present if specified in local profile. Local partners may develop profiles that support use of this element. In the absence of a profile, conformant sending applications will not send the element. Conformant receiving applications will ignore the element if it is sent, unless local profile specifies otherwise. Conformant receiving applications may not raise an error if it receives an unexpected optional element.
X Not Supported The element is not supported. Sending applications should not send this element. Receiving applications should ignore this element if present. A receiving application may raise an error if it receives an unsupported element. Any profile based on this Guide should not specify use of an element that is not supported in this Guide.
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Table 0-2--Usage Code Interpretation for Segments
Usage Code Interpretation Comment
R Required A conforming sending application shall include all “R” segments. Conforming receiving application shall process all required segments. A conforming receiving application must process all required segments. It should raise an error due to the absence of a required segment.
RE Required but may be empty
The segment may be missing from the message, but must be sent by the sending application if there is relevant data. A conforming sending application must be capable of providing all “RE” segments. If the conforming sending application has data for the required segment, then it must send that segment. Receiving applications will be expected to process the data contained in the segment. It must be able to successfully process the message if the segment is omitted (no error message should be generated because the segment is missing).
O Optional This segment may be present if specified in local profile. Local partners may develop profiles that support use of this segment. In the absence of a profile, conforming sending applications will not send the element. Conformant receiving applications will ignore the element if it is sent, unless local profile specifies otherwise.
X Not Supported The segment is not supported. Sending applications should not send this element. Receiving applications should ignore this element if present. Any profile based on this Guide should not specify use of an element that is not supported in this Guide.
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Table 0-43--Usage Code Interpretation specific to MCIR Project
MCIR Usage Code Receiving System Action
R Required by MCIR system.
RE Required by MCIR system, but may be empty.
C Required by MCIR system if condition is true.
X Not supported by MCIR system
MCIR will accept any RSP message which conforms to the HL7 Version 2.5.1 Implementation Guide for Immunization Messaging. It will ignore any data elements and segments which it is not interested in. These will be specified in the segment tables below.
Message Attributes Common to All Messages
The following describe how message specifications will be illustrated in this Guide. These terms will be used in the tables specifying messages throughout this Guide.
Table 0-4--Message Attributes
2 YYY may only be included if XXX is present. XXX may be present without YYY.
Message Attributes
Attribute Description
Segment
Three-character code for the segment and the abstract syntax (i.e., the square and curly braces) [ XXX ] Optional { XXX } Repeating XXX Required (not inside any braces) [{ XXX }] Optional and Repeating [ XXX [YYY] ] YYY is nested within the segment block starting with XXX. It is an optional sub-segment to XXX2 . The whole block is optional. Note that for Segment Groups there will not be a segment code present, but the square and curly braces will still be present.
Name Name of the Segment or Segment group element.
Usage Usage of the segment. Indicates if the segment is required, optional, or not supported in a message. See table with Usage Code Interpretation above.
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Cardinality
Indicator of the minimum and maximum number of times the element may appear. [0..0] Element never present. [0..1] Element may be omitted and it can have at most, one occurrence. [1..1] Element must have exactly one Occurrence. [0..n] Element may be omitted or may repeat up to n times. [1..n] Element must appear at least once, and may repeat up to n times. [0..*] Element may be omitted or repeat for an unlimited number of times. [1..*] Element must appear at least once, and may repeat unlimited number of times. [m..n] Element must appear at least m and, at most, n times.
Segment Attributes Common to All Segments
The abbreviated terms and their definitions, as used in the segment table headings, are as follows:
Table 0-5--Segment Attributes
Abbreviation Description
Seq Sequence of the elements (fields) as they are numbered in the segment
Len
Recommended maximum length of the element. Lengths are provided only for primitive data types. Lengths should be considered recommendations, not absolutes. The receiver may truncate fields, components, and sub-components longer than the recommended length. The receiver should not fail to process a message simply because fields, components, or sub-components are too long.
Data Type Data type used for HL7 element. Data type specifications can be found in Chapter 4.
Usage
Indicates whether the field is supported in this Guide. Indicates if the field, component, or subcomponent is required, optional, or conditional in the corresponding segment, field, or component. See Usage Code Interpretation, above. Note: A required field in an optional segment does not mean the segment must be present in the message. It means that if the segment is present, the required fields within that segment must be populated. The same applies to required components of optional fields. If the field is populated, then the required component must be populated. The same applies to required sub-components of optional components. If a component is populated, the required sub-components of that component must also be populated.
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Abbreviation Description
Cardinality
Indicator of the minimum and maximum number of times the element may appear. [0..0] Element never present. [0..1] Element may be omitted and can have at most, one occurrence. [1..1] Element must have exactly one occurrence. [0..n] Element may be omitted or may repeat up to n times. [1..n] Element must appear at least once, and may repeat up to n times. [0..*] Element may be omitted or repeat for an unlimited number of times. [1..*] Element must appear at least once, and may repeat unlimited number of times. [m..n] Element must appear at least m and, at most, n times.
Item # Unique item identifier in HL7
HL7 Element Name
HL7 descriptor of the element in the segment.
Comment Lists any constraints imposed and other comments in this Guide
The following messages are the only specified in this Implementation Guide.
Table 2-2-Supported Messages
Message Purpose Related Messages Associated Profiles
QBP Request for Evaluated History and Forecast
RSP Z44^CDC
RSP Respond to Request for Immunization Record
QBP Z42^CDC
ACK Send Message Acknowledgement
QBP
Acknowledging a Message—ACK
The ACK returns an acknowledgement to the sending system. This may indicate errors in processing. It is useful for tracking the success of individual queries and for problem solving if queries are not working correctly.
Table 0-3 Message Acknowledgement Segment (ACK)
Segment Cardinality HL7 Usage Comment
MSH (1..1) R
[{SFT}] (0..1) X Not anticipated for use in immunization messages.
MSA (1..1) R
[{ERR}] (0..*) RE Include if there are errors.
Note: For the general acknowledgment (ACK) message, the value of MSH-9-2-Trigger event is equal to the value of MSH-9-2-Trigger event in the message being acknowledged. The value of MSH-9-3-Message structure for the general acknowledgment message is always ACK.
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Request Evaluated History and Forecast Query Profile –Z44^CDCPHINVS
The following query profile supports request of an individual patient immunization history. Implicit in this profile is identity resolution.
Request Evaluated History and Forecast Query Profile
Table 0-4 Request Evaluated History and Forecast Query Profile
Query Statement ID (Query ID=Z44):
Z44
Type: Query
Query Name: Request Evaluated History and Forecast
Query Trigger (= MSH-9): QBP^Q11^QBP_Q11
Query Mode: Both
Response Trigger (= MSH-9): RSP^K11^RSP_K11
Query Characteristics: The query parameters may include demographic and address data. No sorting is expected.
Purpose: The purpose is to request a complete immunization history for one client.
Response Characteristics: In the case where no candidates are found, the response will indicate that no exact matches were found. This may occur when a query finds more than one match.
In the case where exactly one high-confidence candidate is found, an immunization history may be returned.
In the case where receiving system can’t process the query, the receiving system will indicate an error.
Based on Segment Pattern: NA
21
Query Grammar
See the Message segments in the next chapter for specifics of the segments in this message.
Response Grammar Table 0-5-Response Grammar to Different Outcomes
Outcome of Query Response Message
No exact match found3 Response indicates that message was successfully processed and exactly one high confidence match found.
Exactly one high confidence match found4 Response includes a complete immunization history as specified below. See Profile Return Immunization History.
Message is not well formed and has fatal errors or conflicts with local business rules.
Response indicates that the message was not successfully processed and may indicate errors.
Return an Immunization History – Z42^CDCPHINVS
HL7 Version 2.5.1 Message Profile for Returning an Immunization History
Introduction:
A key task that must be accomplished for immunization messaging is requesting an immunization history from another information system. One component of that process is returning an immunization history. This profile constrains the QBP Query, Request Evaluated History and Forecast Query Z44, that is specified above. That query profile specifies the query for requesting an evaluated immunization history and forecast and is
QBP^Q11^QBP_Q11 Query Grammar: QBP Message
HL7 Usage
Comment
MSH Message Header Segment
R The MSH indicates who sent the message and gives other
information about the message.
[{SFT}] Software Segment
O Ignored
QPD Query Parameter Definition
R This segment contains the query parameters.
RCP Response Control Parameter
R This segment contains the expected format of the response
to the query.
[ DSC ] Continuation Pointer
O Ignored
22
intended to support 2 types of response. One response returns a list of candidate client/patients to be the basis of further selection. This response will not be included in this implementation guide. The second is a response that returns an immunization history. This second is the focus of this message profile. The goal of this profile is to constrain the response specified in the Request Evaluated Immunization History and Forecast query profile to a single evaluated immunization history and forecast. In all other aspects it conforms completely with the specifications described in the implementation Guide for this query profile.
Static Definition
Response Grammar RSP^K11 Constrained by This Profile
This profile constrains the Request for Immunization Query Response Grammar by changing the cardinality of the response to one repetition.
Response Grammar RSP^K11
The following table documents the grammar of the RSP^K11 (Z42 profile id) response.
Figure 0-6 Return Immunization History Response Grammar
Segment MCIR Usage Cardinality Comment
MSH R [1..1]
MSA R [1..1]
[ERR] C [0..*] If errors exist, then this segment is populated.
QAK R [1..1]
QPD R [1..1] Query Parameter Definition Segment5
[ [0..1] --- Response control parameter begin
In the case of an error this section is not returned.
Begin patient identifier
PID R (1..1)
[PD1 ] I (0..1)
[{NK1 }] I (0..*)
End Patient Identifier
[ Begin patient visit
PV1 I (0..1)
]
[ Begin Insurance
23
IN1 I (0..1)
] End Insurance
[{ (0..*) Begin Order
ORC R [1..1] Required if client has immunization records (RXA).
There is one ORC for each RXA
Begin Pharmacy Administration
RXA R (1..1)
[RXR ] I (0..1)
[{ I (0..*) Begin Observation
OBX I (1..1)
[{NTE }] I (0..*)
}]
End observation
}]
End Pharmacy Administration End Order
] --- Response control parameter end
This profile indicates that only one repetition of an evaluated history and forecast shall be returned. It shall be identified in MSH-21 by its profile identifier, Z44^CDCPHINVS.
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Chapter 2---QBP and RSP Storyboard
QBP and Response Messages (RSP and ACK)
QBP – Query for Patient
Storyboard Mom (Sarah Snow, maiden name Smith) brings her daughter, Madeline Marie Snow (female, born 7/6/2010), to the Healthy Clinic on 7/6/2012. The family, including Madeline’s dad (John Snow) lives at 123 Main Street, Lansing MI 48837.
Healthy Clinic wants to ensure that their immunization records for Madeline are up to date. Before treating Madeline, Healthy Clinic sends a vaccine query (2.5.1 QBP message, profile Z44) to the MCIR to obtain Madeline’s immunization history and recommendations.
The Clinic includes Madeline’s local registry/MCIR ID (12345678910), her Healthy Clinic medical record number (56979), and her Medicaid number (MI12345) as patient identifiers. In addition to her name, date of birth, and sex, the Clinic also includes Madeline’s address, phone number, mother’s maiden name (Smith).
The MCIR has assigned Healthy Clinic an HL7 facility pin of “1959-99-11”. Healthy Clinic is using version 1.1 of the
electronic medical record (EMR) application “Express Med”.
QBP Message MSH|^~\&|EXPRESSMED1.1|1234-56-78|MCIR|MDCH|20120706131542-0400||QBP^Q11^QBP_Q11|48077894|T|2.5.1|||NE|AL|||||Z44^CDCPHINVS|MYHEALTHSYSTEM|MYCLINIC QPD|Z44^REQUESTEVALUATEDHISTORYAND FORECAST^CDCPHINVS|QT216987|12345678910^^^EMR^LR~56979^^^EMR^MR~MI12345^^^US^MA|SNOW^MADELINE^MARIE^^^^L|SMITH^SARAH^^^^^M|20100706|F|123 MAIN STREET^^LANSING^MI^48837^USA^L|^PRN^^^^517^5551212|Y|1|20120706121736-0400|LOCALEMRID
RCP|I|1^RD|R
RSP – Single Match Found, No Errors
Storyboard When the MCIR QBP Service receives the QBP message from Healthy Clinic for Madeline Snow, it searches for the patient and, finding a single matching patient, the MCIR QBP Service returns a RSP message to Healthy Clinic providing the patient data that the MCIR is permitted to share:
• Patient Data
• MCIRID
• Patient Name (First, Middle, and Last)
• Date of Birth
• Sex
• Evaluated History and Forecast
For each immunization on record, an RXA segment is returned that includes the administration date, vaccine code, and vaccine description.
The RXA segment will also include the lot number, expiration date, and manufacturer associated with the immunization when this information is available.
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Each RXA segment will be followed by one or more OBX segments
Single vs. Multi-Component Vaccines
o If an immunization is a multi-component vaccine, an OBX will be included for each component.
o If the immunization is not a multi-component vaccine only one OBX segment identifying the component will follow the RXA segment.
Invalid Shots
In addition, for the vaccine groups that the MCIR evaluates, if any immunization component is considered not valid (based on the ACIP schedule) the vaccine component OBX segment will be followed by three additional OBX segments.
The first additional OBX segment will indicate that the component was not valid.
The next OBX segment will give the reason the component is invalid.
The final OBX segment indicates that the ACIP schedule was used to determine that the vaccine component was not valid
Immunization Recommendations
Recommendation data, for all the vaccine groups that the MCIR evaluates, will display at the end of the RSP
following the immunization history.
There will be an ORC and an RXA segment pair for each vaccine group. The ORC segment will provide the name
of the vaccine group and the RXA segment will state “no vaccine administered”.
The recommendation data for that vaccine group will display in multiple OBX segments following the OBX/RXA pair.
For recommended vaccines, these OBX segments will contain, along with other data, the recommended vaccine code and the date the next dose is recommended.
For vaccines not recommended or conditionally recommended, an OBX will indicate the vaccine group and the
reason, based on the ACIP schedule.
The RSP message also includes a QPD segment that echoes back the information exactly as it was received in the QPD segment of the query.
From the RSP message, Healthy Clinic now has the following immunization history and recommendations for Madeline Marie Snow (Female, DOB, 07/06/2010, MCIR ID 12345678910):
Vaccine Group History Recommendation Invalid
DTP/DTaP/ DT/Td/Tdap
8-15-2010 9-06-2010
Due Now Does not meet minimum age
Polio 8-15-2010 9-6-2010
Due Now Does not meet minimum age
MMR 9-6-2011 Eligible
HIB 8-15-2010 Due Now
Hepatitis B 7-6-2010 9-6-2011
Due Now
Varicella 9-6-2011 4-4-2012 history of disease
Immune
Pneumococcal 9-6-2010 Due Now
Hep A Due Now
Seasonal Influenza 9-6-2013 Due Now
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RSP – No Match Found, No Errors
Storyboard
Roberto Miguel (Male, DOB 03/31/1979) visits the Healthy Clinic for the first time. The Healthy Clinic, sends a query from Express Med (EMR) to the MCIR QBP Web Service for Roberto’s immunization history using a 2.5.1 QBP message, profile Z44. In addition to Roberto’s name, sex, and date of birth the Healthy Clinic also populates the QBP with Roberto’s medical record number at the Clinic, Insurance member number, address, phone number. The Healthy Clinic does not have a MCIR ID for Roberto or they would also include that in the QBP. The QBP message did not contain any errors.
When the MCIR QBP Web Service receives the QBP, it searches for the patient and returns an RSP letting the clinic know that no matching patient was found. Since there were no errors in the QBP, in the RSP message QAK-2 (Query Response Status) will contain a value of “NF” indicating no matching patients were found and MSA-1 (Acknowledgement Code) will be valued with “AA” indicating there were no errors.
RSP Message MSH|^~\&|MCIR|MDCH|EXPRESS MED1.1|5555R55|20121023125341-0400||RSP^K11^RSP_K11|20121023125341-0400|P|2.5.1|||NE|NE|||||Z42^CDCPHINVS|
MSA|AA|23487290874920|
QAK|QT130473|NF|Z44^REQUESTEVALUATEDHISTORYAND FORECAST^CDCPHINVS|
QPD|Z44^REQUEST EVALUATEDHISTORYAND FORECAST^CDCPHINVS|QT130473|SACHS239870^^^ExpressMed1.1^MR~AA33233S^^^^MA|MIGUEL^ROBERTO^^^^^L||19790331|M| 1234
MICHIGANAVE^^LANSING^MI^48337^^P|^PRN^^^^347^3962491|N||20120909120000|HEALTHYCLINIC|
RSP – Too Many Matches Found, No Errors Storyboard A new patient, Justin Howe (Male, DOB 02/03/2000), visits the Healthy Clinic for the first time. The Healthy Clinic sends a query to the MCIR QBP Web Service for Justin’s immunization history; using a 2.5.1 QBP message, profile Z44. The only information Healthy Clinic includes in the query is Justin’s first and last name, sex, and date of birth. Other information that could be used to search for a matching patient, such as Justin’s MCIR ID, medical record number with the Clinic, middle name, address, phone number, and mother’s maiden name, were known by the clinic but not included in the query. While the QBP message was only minimally populated with data, it did not contain any errors.
When the MCIR QBP Web Service receives the QBP, it searches for the patient and returns an RSP letting the Healthy Clinic know that too many (more than one) matching patient was found. Since there were no errors in the QBP, in the RSP message QAK-2 (Query Response Status) will contain a value of “TM” indicating too many matching patients were found and MSA-1(Acknowledgement Code) will be valued with “AA” indicating there were no errors.
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RSP Message MSH|^~\&|MCIR|MDCH|Express Med 1.1|1234-56-78|20121207152412- 0500||RSP^K11^RSP_K11|20121207152412-0500|T|2.5.1|||NE|NE|
MSA|AA|723020802738590|
QAK|QT216987|TM|
QPD|Z44^REQUESTEVALUATEDHISTORYANDFORECAST^CDCPHINVS|QT216987||Howe^Justin^^^^^L||20000203|M|
QBP and RSP – Patient Deceased, No Errors
Healthy Clinic is querying MCIR on patients that have not been seen in over a year in their clinic for an update on their immunization history. The Healthy Clinic sends a query to the MCIR QBP Web Service for Regan Winneshiek (Male, DOB 11/10/1946) using a 2.5.1 QBP message, profile Z44. The only information Healthy Clinic includes in the query is the patients first and last name, sex, and date of birth.
When the MCIR QBP Web Service receives the QBP, it searches for the patient and returns an RSP letting the Healthy Clinic know that Regan Winneshiek is documented as deceased in the registry. Since there were no errors in the QBP, in the RSP message QAK-2 (Query Response Status) will contain a value of “NF” indicating the patients was not found and MSA-1(Acknowledgement Code) will be valued with “AA” indicating there were no errors.
QBP Message
MSH|^~\&|EPXRESSMED1.1|1234-56-
78|MCIR|MCIR|201311080500||QBP^Q11^QBP_Q11|1383952742978.17|P|2.5.1|||NE|AL|||||Z44^CDCPHINVS|MYHEALTHSYSTEM|MYCLINIC
QPD|Z44^REQUESTEVALUATEDHISTORYANDFORECAST^CDCPHINVS|1383952742978.17|V40C20^^^OISTEST^MR|WINNESHIEK^REGAN^^^^^||19461110|M
RCP|I|20
RSP Message
MSH|^~\&|MCIR|MDCH|EXPRESS MED1.1|5555R55|20121023125341-0400||RSP^K11^RSP_K11|20121023125341-0400|P|2.5.1|||NE|NE|||||Z42^CDCPHINVS|MYHEALTHSYSTEM|MYCLINIC
MSA|AA|23487290874920|
QAK|QT130473|NF|Z44^REQUESTEVALUATEDHISTORYANDFORECAST^CDCPHINVS|
QPD|Z44^REQUESTEVALUATEDHISTORYANDFORECAST^CDCPHINVS|1383952742978.17|V40C20^^^OISTEST^MR|WINNESHIEK^REGAN^^^^^||19461110|M
QBP and RSP – Patient Opted Out of MCIR, No Errors
Natale Star (Male, DOB 11/30/2012) visits the Healthy Clinic for the first time. The Healthy Clinic, sends a query from Express Med (EMR) to the MCIR QBP Web Service for Natale’s immunization history using a 2.5.1 QBP message, profile
Z44. In addition to Natale’s name, sex, and date of birth the Healthy Clinic also populates the QBP with address, and phone number. The QBP message did not contain any errors.
When the MCIR QBP Web Service receives the QBP, it searches for the patient and returns an RSP letting the clinic know that no matching patient was found. Natalie is documented in MCIR with an Opt-Out Status. MCIR cannot send any immunization data back in the RSP on Opt-Out Statues. Since there were no errors in the QBP, in the RSP message QAK-2 (Query Response Status) will contain a value of “NF” indicating no matching patients were found and MSA-1 (Acknowledgement Code) will be valued with “AA” indicating there were no errors.
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QBP Message
MSH|^~\&|EXPRESS MED|HEALTHY CLINIC|MCIR|MDCH|1234-56-78|201311090500||QBP^Q11^QBP_Q11|1384018326342.25|P|2.5.1|||NE|AL|||||Z44^CDCPHINVS|MYHEALTHSYSTEM|MYCLINIC
QPD|Z44^REQUESTEVAULATEDHISTORYANDFORECAST^CDCPHINVS|1384018326342.25|I89L28^^^OIS-TEST^MR|STAR^MONTANA^NATALE^^^^L|FARRELL^VIENNA|20121130|M|136 STREET AVE^^NILES^MI^49120^USA^L|^PRN^PH^^^269^4441111
RCP|I|20
RSP Message
MSH|^~\&|MCIR|MDCH|EXPRESS MED|1234-56-78|201311090501||RSP^K11^RSP_K11|20131109125341-0600|P|2.5.1|||NE|NE|||||Z42^CDCPHINVS|
MSA|AA|23487290874920|
QAK|QT130473|NF|Z42^REQUESTIMMUNIZATIONHISTORY^HL70471|
QPD|Z44^REQUESTEVALUATEDHISTORYANDFORECAST^CDCPHINVS|1384018326342.25|I89L28^^^OIS-TEST^MR|STAR^MONTANA^NATALE^^^^L|FARRELL^VIENNA|20121130|M|136 STREET AVE^^NILES^MI^49120^USA^P|^PRN^PH^^^269^4441111
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Chapter 3 Segments and Fields
This chapter will specify only the segments and fields of interest for the MCIR project.
Segments that are not described below may be found in the HL7 Version 2.5.1 Implementation Guide for Immunization Messaging. The segments below include:
FHS – File Header Segment
FTS – File Trailer Segment
MSH - Message Segment Header for Query
MSH – Message Segment Header for Response
PID – Person Identifier Segment
ORC – Order Segment
QAK – Query acknowledgement Segment
QPD – Query parameter segment
RCP – Response Control segment
RXA – Medication Administered segment (immunization event record)
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MSH - MESSAGE HEADER SPECIFICATION
Table 0-1 MSH Specification for Request Immunization History Query
SEQ
LEN
Data Type
Cardinality
Value set
ITEM #
ELEMENT NAME
HL7 Usage
MCIR Usage
Constraint
1 1 ST [1..1] 00001 Field Separator
R R The MSH.1 field shall be |
2 4 ST [1..1] 00002 Encoding Characters
R R The MSH.2 field shall be ^~\&
3 HD [0..1] 0361 00003 Sending Application
RE RE This is the system that created this message.
4 HD [0..1] 0362 00004 Sending Facility
RE R This is the Immunization History Consumer.
5 HD [0..1] 0361 00005 Receiving Application
RE R This is the system that is receiving this message.
6 HD [0..1] 0362 00006 Receiving Facility
RE R This is the Immunization History Consumer or the Immunization History supplier, depending on the message.
7 26 TS [1..1] 00007 Date/Time Of Message
R R The degree of precision must be at least to the second, and the time zone must be included (format YYYYMMDDHHMMSS[.S[S[S[S]]]]+/-ZZZZ).
8 40 ST [0..1] 00008 Security O X
9 15 MSG [1..1] 00009 Message Type
R R QBP^Q11^QBP_Q11
10 20 ST [1..1] 00010 Message Control ID
R R
11 3 PT [1..1] 00011 Processing ID R R
12 VID [1..1] 00012 Version ID R R 2.5.1
13 15 NM [0..1] 00013 Sequence Number
O X
14 180
ST [0..1] 00014 Continuation Pointer
O X
15 2 ID [0..1] 0155 00015 Accept Acknowledgment Type
R R NE-Never
16 2 ID [0..1] 0155 00016 Application Acknowledgment Type
R R AL-Always
31
SEQ LEN Data Type Cardinality
Value set
ITEM #
ELEMENT NAME
HL7 Usage
MCIR Usage
Constraint
17 3 ID [0..1] 0399 00017 Country Code X X blank
18 16 ID [0..1] 0211 00692 Character Set X X blank
19 CE [0..1] 00693 Principal Language Of Message
X X blank
20 20 ID [0..1] 0356 01317 Alternate Character Set Handling Scheme
X X blank
21 EI [1..1] 01598 Message Profile Identifier
R R Z34^ CDCPHINVS
Z44^ CDCPHINVS
22 XON Sending Responsible Organization
RE RE Health system or HIE submitting data on behalf of a clinic
23 XON Receiving Responsible Organization
RE RE The actual clinic or hospital
32
MSH - MESSAGE HEADER SPECIFICATION
Table 0-2 MSH Specification for Request Immunization History Response
SEQ
LEN Data Type
Cardinality
Value set
ITEM # ELEMENT NAME
HL7 Usage
MCIR
Usage
Constraint
1 1 ST [1..1] 00001 Field Separator
R R The MSH.1 field shall be |
2 4 ST [1..1] 00002 Encoding Characters
R R The MSH.2 field shall be ^~\&
3 HD [0..1] 0361 00003 Sending Application
RE RE This is the system that created this message.
4 HD [0..1] 0362 00004 Sending Facility
RE R This is the Immunization History Consumer or the Immunization History supplier, depending on the message.
5 HD [0..1] 0361 00005 Receiving Application
RE R This is the system that is receiving this message.
6 HD [0..1] 0362 00006 Receiving Facility
RE R This is the Immunization History Consumer or the Immunization History supplier, depending on the message.
7 26 TS [1..1] 00007 Date/Time Of Message
R R The degree of precision must be at least to the second, and the time zone must be included (format YYYYMMDDHHMMSS[.S[S[S[S]]]]+/-ZZZZ).
8 40 ST [0..1] 00008 Security O X
9 15 MSG [1..1] 00009 Message Type
R R RSP^K11^RSP_K11
10 20 ST [1..1] 00010 Message Control ID
R R
11 3 PT [1..1] 00011 Processing ID
R R
12 VID [1..1] 00012 Version ID R R 2.5.1
33
SEQ LEN Data Type
Cardinality Value set
ITEM # ELEMENT NAME
HL7 Usage
MCIR
Usage
Constraint
13 15 NM [0..1] 00013 Sequence Number
O X
14 180 ST [0..1] 00014 Continuation Pointer
O X
15 2 ID [0..1] 0155 00015 Accept Acknowledgment Type
R R NE-Never
16 2 ID [0..1] 0155 00016 Application Acknowledgment Type
R R AL-Always
17 3 ID [0..1] 0399 00017 Country Code X X blank
18 16 ID [0..1] 0211 00692 Character Set X X blank
19 CE [0..1] 00693 Principal Language Of Message
X X blank
20 20 ID [0..1] 0356 01317 Alternate Character Set Handling Scheme
X X blank
21 EI [1..1] 01598 Message Profile Identifier
R R Z44^ CDCPHINVS
22 XON Sending Responsible Organization
RE RE Health System or HIE submitting data in behalf of a clinic or hospital
23 XON Receiving Responsible
Organization
RE RE Actual clinic or hospital
ORC—Order Request Segment
The Common Order segment (ORC) is used to transmit fields that are common to all orders (all types of services that are requested). While not all immunizations recorded in an immunization message are able to be associated with an order, each RXA must be associated with one ORC, based on HL7 2.5.1 standard.
34
Table 0-3 Common Order Segment (ORC)
SEQ LEN Data Type
Cardinality Value Set
ITEM# ELEMENT NAME HL7
Usage
MCIR
Usage
Comment
1 2 ID [1..1] 0119 00215 Order Control R R use RE
2 EI [0..1] 00216 Placer Order Number
RE X See Guidance below.
3 EI [1..1] 00217 Filler Order Number
R R Vaccine ID may change if a record is merged in MCIR
4 EI [0..1] 00218 Placer Group Number
O X
5 2 ID [0..1] 0038 00219 Order Status O X
6 1 ID [0..1] 0121 00220 Response Flag O X
7 TQ [0..0] 00221 Quantity/Timing X X
8 EIP [0..1] 00222 Parent O X
9 TS [0..1] 00223 Date/Time of Transaction
O X
10 XCN [0..1] 00224 Entered By RE X This is the person that entered this immunization record into the system.
11 XCN [0..1] 00225 Verified By O X
12 XCN [0..1] 00226 Ordering Provider
RE X This shall be the provider ordering the immunization. It is expected to be empty if the immunization record is transcribed from a historical record.
13 PL [0..1] 00227 Enterer’s Location
O X
14 XTN [0..1] 00228 Call Back Phone Number
O X
15 TS [0..1] 00229 Order Effective Date/Time
O X
16 CE [0..1] 00230 Order Control Code Reason
O X
17 CE [0..1] 00231 Entering Organization
O X This is the provider organization that entered this record/order.
35
SEQ LEN Data Type
Cardinality Value Set
ITEM# ELEMENT NAME
HL7
Usage
MCIR
Usage
Comment
18 CE [0..1] 00232 Entering Device O X
19 XCN [0..1] 00233 Action By O X
20 CE [0..1] 01310 Advanced Beneficiary Notice Code
O X
21 XON [0..1] 01311 Ordering Facility Name
O X
22 XAD [0..1] 01312 Ordering Facility Address
O X
23 XTN [0..1] 01313 Ordering Facility Phone Number
O X
24 XAD [0..1] 01314 Ordering Provider Address
O X
25 CWE [0..1] 01473 Order Status Modifier
O X
26 CWE [0..1] 01641 Advanced Beneficiary Notice Override Reason
O X
27 TS [0..1] 01642 Filler’s Expected Availability Date/Time
O X
28 CWE [0..1] 00615 Confidentiality Code
O X
29 CWE [0..1] 01643 Order Type O X
30 CNE [0..1] 01644 Enterer Authorization Mode
O X
31 CWE [0..1] 02286 Parent Universal Service Identifier
O X
ORC field definitions
ORC-1 Order Control (ID) 00215
Definition: Determines the function of the order segment.
The value for VXU and RSP shall be RE.
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Placer Order Number (ORC-2) and Filler Order Number (ORC-3) are unique identifiers from the system where an order was placed and where the order was filled. They were originally designed for managing lab orders. These fields have a usage status of Conditional in Version 2.5.1. The condition for each is that they must be present in either the OBR or ORC of a message. There has been confusion about usage for these fields. The Orders and Observations workgroup has addressed this confusion. In the context that ORC will be used in Immunization messaging either ORC-2 or ORC-3 must be populated. They may both be populated.
In the immunization context, it is not common to have one system placing and one filling an immunization order. In some cases neither is known. The use case that these have supported is to allow a system that sent an immunization record to another system to identify an immunization that needs to be changed using the Filler Order Number it had sent.
This Guide specifies that Placer Order Number is RE (required, but may be empty). The Filler Order Number SHALL be the unique immunization id of the sending system.
ORC-2 Placer Order Number (EI) 00216
The placer order number is used to uniquely identify this order among all orders sent by a provider organization.
ORC-2 is a system identifier assigned by the placer software application. The Placer Order Number and the Filler Order Number are essentially foreign keys exchanged between applications for uniquely identifying orders and the associated results across applications.
In the case where the ordering provider organization is not known, the sending system may leave this field empty.
ORC-3 Filler Order Number (EI) 00217
The filler order number is used to uniquely identify this order among all orders sent by a provider organization that filled the order.
This shall be the unique identifier of the sending system in a given transaction. In the case where system A sends the record to system B and system B then forwards to system C, system B will send its’ own unique identifier.
Use of this foreign key will allow the initiating system to accurately identify the previously sent immunization record, facilitating update or deletion of that record.
In the case where a historic immunization is being recorded (i.e. from an immunization card), the sending system SHALL assign an identifier as if it were an immunization administered by a provider associated with the provider organization owning the sending system.
In the case where an RXA is conveying information about an immunization which was not given (e.g. refusal) the filler order number shall be 9999.
Note that the receiving system will need to store this value in addition to its own internal id in order for this to be used.
ORC-10 Entered By (XCN) 00224
Definition: This identifies the individual that entered this particular order. It may be used in conjunction with an RXA to indicate who recorded a particular immunization.
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ORC-12 Ordering Provider (XCN) 00226
Definition: This field contains the identity of the person who is responsible for creating the request (i.e., ordering physician). In the case where this segment is associated with a historic immunization record and the ordering provider is not known, then this field should not be populated.
ORC-17 Entering Organization (CE) 00231
Definition: This field identifies the organization that the enterer belonged to at the time he/she enters/maintains the order, such as medical group or department. The person who entered the request is defined in ORC-10 -entered by.
ORC-21 Ordering Facility Name (XON) 01311
Definition: This field contains the name of the facility placing the order. It is the organization sub-unit that ordered the immunization. (i.e. the clinic)
ORC-22 Ordering Facility Address (XAD) 01312
Definition: This field contains the address of the facility requesting the order.
ORC-23 Ordering Facility Phone Number (XTN) 01312
Definition: This field contains the phone number of the facility requesting the order.
ORC-24 Ordering Provider Address (XAD) 01314
Definition: This field contains the address of the care provider requesting the order.
PID—Patient Identifier Segment
The PID is used by all applications as the primary means of communicating patient identification information. This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently.
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TABLE 0-4-PATIENT IDENTIFIER SEGMENT (PID)
SEQ LEN Data Type
Cardinality Value Set
ITEM# Element Name
HL7 Usage
MCIR
Usage
Constraint
1 4 SI [0..1] 00104 Set ID - PID
RE RE
2 CX [0..0] 00105 Patient ID
X RE MCIR ID and Patient ID if available
3 CX [1..*] 00106 Patient Identifier List
R R
4 CX [0..0] 00107 Alternate Patient ID - 00106
X X
5 XPN [1..*] 00108 Patient Name
R R the first repetition shall contain the legal name. Multiple given names or initials are separated by spaces.
6 XPN [0..1] 00109 Mother’s Maiden Name
RE X
7 TS [1..1] 00110 Date/Time of Birth
R R Required, must have month, day and year.
8 1 IS [0..1]
0001
00111 Administrative Sex
RE R M= male, F = female, U = not determined/unspecified/unknown.
9 XPN [0..0] 00112 Patient Alias
X X This field should not be used. It was supported in earlier implementations.
10 CE [0..*] 0005 00113 Race O X The first triplet is to be used for the alpha code. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) should be used for governmentally assigned numeric codes (####-#).
11 XAD [0..*] 00114 Patient Address
O RE The first repetition should be the primary address.
12 4 IS [0..0] 0289 00115 County Code
X X County belongs in address field.
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SEQ LEN Data Type
Cardinality Value Set
ITEM# Element Name
HL7 Usage
MCIR
Usage
Constraint
13 XTN [0..*] 00116 Phone Number - Home
O X The first instance shall be the primary phone number.
Only one item is allowed per repetition.
14 XTN [0..*] 00117 Phone Number - Business
O X
15 CE [0..1] ISO0639
00118 Primary Language
O X Use ISO 639.
16 CE [0..1] 0002
00119 Marital Status
O X
17 CE [0..1] 0006 00120 Religion O X
18 CX [0..1] 00121 Patient Account Number
O X
19 16 ST [0..0] 00122 SSN Number - Patient
X X
20 DLN [0..0] 00123 Driver’s License Number - Patient
X X
21 CX [0..0] 00124 Mother’s Identifier
X X
22 CE [0..1] 0189 00125 Ethnic Group O X First triplet shall contain H,N,U if populated. Second triplet shall contain government issued code from table xxx, if populated. If both are populated, they must match logically.
23 60 ST [0..1] 00126 Birth Place O X Use may be specified locally.
24 1 ID [0..1] 0136 00127 Multiple Birth Indicator
O X The acceptable values are Y and N. If the status is undetermined, then field shall be empty.
25 2 NM [0..1] 00128 Birth Order O X If Multiple Birth Indicator is populated with Y, then this field should contain the number indicating the person’s birth order, with 1 for the first child born and 2 for the second.
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SEQ LEN Data Type
Cardinality Value Set
ITEM# Element Name
HL7 Usage
MCIR
Usage
Constraint
26 CE [0..1] 0171 00129 Citizenship O X
27 CE [0..1]
0172
00130 Veterans Military Status
O X
28 CE [0..1] 0212 00739 Nationality O X
29 TS [0..1] 00740 Patient Death Date and Time
O X
30 1 ID [0..1] 0136 00741 Patient Death Indicator
O X If patient death date is populated, then this field should be populated.
31 1 ID [0..1] 0136 01535 Identity Unknown Indicator
O X
32 20 IS [0..1]
0445
01536 Identity Reliability Code
O X
33 TS [0..1] 01537 Last Update Date/Time
O R
34 HD [0..1] 01538 Last Update Facility
O X
35 CE [0..1] 0446 01539 Species Code O X
36 CE [0..1] 0447 01540 Breed Code O X
37 80 ST [0..1] 01541 Strain O X
38 CE [0..1] 0429
01542 Production Class Code
O X
39 CWE [0..1] 0171
01840 Tribal Citizenship
O X
PID field definitions
PID-1 Set ID - PID (SI) 00104
Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. In this profile it shall always be 1.
PID-3 Patient Identifier List (CX) 00106
Definition: This field contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient (e.g., medical record number, billing number, birth registry, national unique individual identifier, etc.).
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PID-5 Patient Name (XPN) 00108
Definition: This field contains the names of the patient, The primary or legal name of the patient is reported first. Therefore, the name type code in this field should be “L - Legal”. Refer to HL7 Table 0200 - Name Type for valid values.
PID-6 Mother’s Maiden Name (XPN) 00109
Definition: This field contains the family name under which the mother was born (i.e., before marriage). It is used to distinguish between patients with the same last name.
PID-7 Date/Time of Birth (TS) 00110
Definition: This field contains the patient’s date and time of birth.
PID-8 Administrative Sex (IS) 00111
Definition: This field contains the patient’s sex. Refer to User-defined Table 0001 - Administrative Sex for suggested values.
PID-10 Race (CE) 00113
Definition: This field refers to the patient’s race. Refer to User-defined Table 0005 - Race for suggested values. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.
PID-11 Patient Address (XAD) 00114
Definition: This field contains the mailing address of the patient. Address type codes are defined by HL7 Table 0190 - Address Type. Multiple addresses for the same person may be sent in the following sequence: The primary mailing address must be sent first in the sequence (for backward compatibility); if the mailing address is not sent, then a repeat delimiter must be sent in the first sequence.
This field is used for any type of address that is meaningfully associated with the client/patient. For instance Birth State is the state of the address of the birthing location, address type = BDL.
A person’s address may be sent in this field or in the NK1 segment with a relationship code indicating Self. Local implementations should clarify how these addresses will be handled.
PID-13 Phone Number - Home (XTN) 00116
Definition: This field contains the patient’s personal phone numbers. All personal phone numbers for the patient are sent in the following sequence. The first sequence is considered the primary number (for backward compatibility). If the primary number is not sent, then a repeat delimiter is sent in the first sequence. Each type of telecommunication shall be in its’ own repetition. For example, if a person has a phone number and an email address, they shall each have a repetition. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type for valid values.
PID-22 Ethnic Group (CE) 00125
Definition: This field further defines the patient’s ancestry. Refer to User-defined Table 0189 - Ethnic Group. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.
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QAK—Query Acknowledgement Segment
Table 0-5-Query Acknowledgement Segment
SEQ LEN Data Type
Cardinality Value set
ITEM# ELEMENT NAME HL7
Usage
MCIR Usage
Comment
1 32 ST [1..1] 00696 Query Tag R R
2 2 ID [0..1] 0208 00708 Query Response Status
RE R AA, AE, AR, NF, TM
3 CE [0..1] 0471 01375 Message Query Name
R R
4 10 NM [0..1] 01434 Hit Count O X
5 10 NM [0..1] 01622 This payload O X
6 10 NM [0..1] 01623 Hits remaining O X
QAK field definitions
QAK-1 Query Tag (ST) 00696
Definition: This field contains the value sent in QPD-2 (query tag) by the initiating system, and will be used to match response messages to the originating query. The responding system is required to echo it back as the first field in the query acknowledgement segment (QAK).
QAK-2 Query Response Status (ID) 00708
Definition: This field allows the responding system to return a precise response status. It is especially useful in the case where no data is found that matches the query parameters, but where there is also no error. It is defined with HL7 Table 0208 - Query Response Status.
QAK-3 Message Query Name (CE) 01375
Definition: This field contains the name of the query. This shall mirror the QPD-1 (Message Query Name) found in the query message that is being responded to.
QPD Input Parameter Specification (Z44)
Table 0-6 QPD Input Parameter Specification
Field Seq (Query ID=Z44) Name LEN TYPE Opt Rep MCIR
Usage
Segment Field Name
Element Name or Value
1 Message Query Name
CE R R Z44^Request Evaluated History and Forecast^CDCPHINVS
2 Query Tag 32 ST R R
3 Patient List CX RE Y R PID.3 PID-3: Patient Identifier List6
4 Patient Name XPN RE R PID.5 PID-5: Patient Name
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Field Seq (Query ID=Z44) Name LEN TYPE Opt Rep MCIR
Usage
Segment Field Name
Element Name or Value
5 Patient Mother Maiden Name
XPN RE RE PID.6 PID-6: Mother’s maiden name
6 Patient Date of Birth
26 TS RE R PID.7 PID-7: Patient date of birth
7 Patient Sex 1 IS RE R PID.8 PID-8: Patient sex
8 Patient Address XAD RE RE PID.11 PID-11: Patient Address
9 Patient home phone
XTN RE RE PID.13 PID-13: Patient home phone
10 Patient multiple birth indicator
1 ID RE RE PID-24 PID-24: Patient multiple birth indicator
11 Patient birth order
2 NM RE RE PID-25 PID-25: Patient birth order
12 Client last updated date
TS RE X PID-33 PID-33: Patient last update date
13 Client last update facility
HD RE X PID-34 PID-34: Patient last update facility
14 Guardian or Next of Kin Name
XPN RE RE NK1- 2
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QPD Input Parameter Field Description and Commentary Table 0-7 QPD Input Parameter Field Description and Commentary
Input Parameter (Query ID=Z44)
Comp. Name DT Description
MessageQueryName CE Z44^Request Evaluated History and Forecast^CDCPHINVS
QueryTag ST Unique to each query message instance. System generated.
PatientList CX The combination of values for Patientlist.ID, patientlst.identifiercode and Patientlist.AssigningAuthority are intended to allow unique identification of a client, if the data are found in the responding system.
ID ST If this field, PID.3.1, is not valued, PatientList is not considered when seeking matching clients.
Assigning Authority
HD If this field, PID.3.4, is not valued, PatientList is not considered when seeking matching clients.
IdentifierTypeCode IS If this field, PID.3.5, is not valued, PatientList is not considered when seeking matching clients.
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Input Parameter (Query ID=Z44)
Comp. Name DT Description
PatientName XPN If this field, PID.5, is not valued, then the query will return an error, since this is a required field.
Family Name FN If this field, PID.5.1, is not valued, then patient name is considered to contain no value.
Given Name ST If this field, PID.5.2, is not valued, then patient name is considered to contain no value. Given name is required.
Second or further names
ST If this field, PID.5.3, is not valued, then all values for this field are considered a match.
Suffix ST If this field, PID.5.4, is not valued, then all values for this field are considered a match.
Mother’s Maiden Name XPN If this field, PID.6, is not valued, Mother’s maiden name is not considered when seeking matching clients.
Family Name FN If this field, PID.6.1, is not valued, then mother’s maiden name is considered to contain no value.
Given Name ST If this field, PID.6.2, is not valued, then all values for this field are considered a match.
DateOfBirth TS If this field, PID.7, is not valued to an accuracy of at least day, then this field is considered not valued.
Sex IS If this field, PID.8, is not valued, then all values for this field are considered a match.
Address XAD If this field, PID.11, is not valued, then address will not be considered when seeking matching clients.
Street Address
SAD If this field, PID.11.1, is not valued, then all values for this field are considered a match.
City ST If this field, PID.11.3, is not valued, then address is considered to contain no value.
State ST If this field, PID.11.4, is not valued, then address is considered to contain no value.
ZIP ST If this field, PID.11.5, is not valued, then all values for this field are considered a match.
Address Type
IS If this field, PID.11.7 is not valued, then it shall default to L, legal address.
Phone XTN This field will be considered the Home phone. If this field, PID.13, is not valued, then phone number is not considered when seeking matching clients.
Area code NM If this field, PID.13.6, is not valued, then all values for this field shall be considered matches.
Local number
NM If this field, PID.13.7, is not valued, then address is considered to contain no value.
Input Parameter (Query ID=Z44)
Comp. Name
DT Description
Multiple Birth Indicator
ID If this field, PID.24, is not valued, then Multiple Birth Indicator is not considered when seeking matching clients.
Birth Order NM If this field, PID.25, is not valued, then birth order is not considered when seeking matching clients.
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Client last updated date
TS If this field, PID.33, is not valued, then client last updated date is not considered when seeking matching clients.
Client last update facility
TS If this field, PID.34, is not valued, then client last updating facility is not considered when seeking matching clients.
RCP Response Control Parameter Field Description and Commentary
Table 0-8 RCP Response Control Parameter Field Description and Commentary
Field Seq (Query ID=Z44)
Name Component Name
LEN DT Description
1 Query Priority 1 ID If this field is not valued then it shall default to I. The only value permitted is I.
2 Quantity Limited Request
10 CQ
Quantity NM The maximum number of patients that may be returned. This shall be valued as 1 (one).
Units CWE This value shall be RD (records)
3 Response Modality 60 CWE Default is R. REAL-TIME
7 Segment group inclusion
256 ID This field shall be empty.
RXA—Pharmacy/Treatment Administration Segment
The RXA segment carries pharmacy administration data. It is a child of an ORC segment, which a repeating segment in the RSP and. Because ORC are allowed to repeat an unlimited numbers of vaccinations may be included in a message. Each RXA must be preceded by an ORC.7
Table 0-9 Pharmacy/Treatment Administration (RXA)(Z42)
.
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SEQ LEN Data
Type
Cardinality Value Set ITEM # ELEMENT NAME HL7 Usage MCIR
Usage
Comment
1 4 NM [1..1] 00342 Give Sub-ID Counter R R Constrain to 0 (zero)
2 4 NM [1..1] 00344 Administration Sub-ID Counter
R R Constrain to 1
3 TS [1..1] 00345 Date/Time Start of Administration
R R This segment may be used in cases where a vaccine has not been administered. For instance a patient may refuse a vaccination or the sending system may be forecasting a next dose due. See notes below for guidance on the relevant date to include here.
4 TS [0..1] 00346 Date/Time End of Administration
O X If populated, this should be the same as Start time (RXA-3)
5 CE [1..1] 0292 00347 Administered Code R R CVX code is strongly preferred.
6 20 NM [1..1] 00348 Administered Amount O O If administered amount is not recorded, use 999.
7 CE [0..1] 00349 Administered Units O O If previous field is populated by any value except 999, it is required.
8 CE [0..1] 00350 Administered Dosage Form
O X
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SEQ LEN Data
Type
Cardinality Value Set ITEM # ELEMENT NAME HL7 Usage MCIR
Usage
Comment
9 CE [0..*] NIP 0001
00351 Administration Notes O RE The primary use of this field it to convey if this immunization record is based on a historical record or was given by the provider recording the immunization. All systems should be able to support this use. Other uses of this field are permitted, but need to be specified locally.
10 XCN [0..1] 00352 Administering Provider
O X
11 LA2 [0..1] 00353 Administered-at Location
O X
12 20 ST [0..1] 00354 Administered Per (Time Unit)
O X
13 20 NM [0..1] 01134 Administered Strength O X
14 CE [0..1] 01135 Administered Strength Units
O X
15 20 ST [0..*] 01129 Substance Lot Number O RE
16 TS [0..1] 01130 Substance Expiration Date
O X
17 CE [0..*] 0227 01131 Substance Manufacturer Name
O RE
18 CE [0..*] NIP002 01136 Substance/Treatment Refusal Reason
C X
19 CE [0..1] 01123 Indication O X
20 2 ID [0..1] 0322 01223 Completion Status RE R
21 2 ID [0..1] 0323 01224 Action Code - RXA O RE
22 TS [0..1] 01225 System Entry Date/Time
O X
23 5 NM [0..1] 01696 Administered Drug Strength Volume
O X
24 CWE [0..1] 01697 Administered Drug Strength Volume Units
O X
25 CWE [0..1] 01698 Administered Barcode Identifier
O X
26 1 ID [0..1] 0480 01699 Pharmacy Order Type O X
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RXA field definitions
RXA-1 Give Sub-ID Counter (NM) 00342
Definition: This field is used to match an RXA and RXG. Not a function under IIS.
Constrain to 0 (zero).
RXA-2 Administration Sub-ID Counter (NM) 00344
Definition: This field is used to track multiple RXA under an ORC. Since each ORC has only one RXA in immunization messages, constrain to 1. This should not be used for indicating dose number, which belongs in an OBX.
Note that the previous Implementation Guide suggested that this be used for indicating dose number. This use is no longer supported.
RXA-3 Date/Time Start of Administration (TS) 00345
Definition: The date this vaccination occurred. In the case of refusal or deferral, this is the date that the refusal or deferral was recorded. In the case of a forecast dose, this is the date the forecast was made.
RXA-4 Date/Time End of Administration (If Applies) (TS) 00346
Definition: In the context of immunization, this is equivalent to the Start date/time. If populated it should be = RXA-3. If empty, the date/time of RXA-3-Date/Time Start of Administration is assumed.
RXA-5 Administered Code (CE) 00347
Definition: This field identifies the medical substance administered. If the substance administered is a vaccine, CVX codes should be used in the first triplet to code this field (see HL7 Table 0292 - Codes for vaccines administered). The second set of three components could be used to represent the same vaccine using a different coding system, such as Current Procedural Terminology (CPT). CVX code is the strongly preferred code system.
RXA-6 Administered Amount (NM) 00348
Definition: This field records the amount of pharmaceutical administered. The units are expressed in the next field, RXA-7. Registries that do not collect the administered amount should record the value “999” in this field.
RXA-7 Administered units (CE) 00349
Definition: This field is conditional because it is required if the administered amount code does not imply units. This field must be in simple units that reflect the actual quantity of the substance administered. It does not include compound units. This field is not required if the previous field is populated with 999.
RXA-9 Administration Notes (CE) 00351
Definition: This field is used to indicate whether this immunization record is based on a historical record or was given by the reporting provider. It should contain the information source (see NIP-defined Table 0001 - Immunization Information Source). The first component shall contain the code, the second the free text and the third shall contain the name of the code system. (NIP001) Sending systems should be able to send this information. Receiving systems should be able to accept this information.
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This field may be used for other notes if specified locally. The first repetition shall be the information source. If other notes are sent when information source is not populated, then the first repetition shall be empty.
Other notes may include text only in component 2 of the repeat. Acceptance of text only is by local agreement only.
Information source is an NVAC core data element. It speaks to the reliability of the immunization record. IIS rely on this information.
RXA-10 Administering Provider (XCN) 00352
Definition: This field is intended to contain the name and provider ID of the person physically administering the pharmaceutical.
Note that previous Implementation Guide (2.3.1) overloaded this field by using local codes to indicate administering provider, ordering provider and recording provider. This is a misuse of this field and not supported in this Guide. The ordering and entering providers are indicated in the associated ORC segment.
RXA-11 Administered-at Location (LA2) 00353
Definition: The name and address of the facility that administered the immunization. Note that the components used are:
Component 4: The facility name/identifier.
Subcomponent 1:identifier8
Subcomponent 2: Universal ID this shall be an OID, if populated. Note that this should not be a local code, but rather a universal id code.
Subcomponent 3: Universal ID type (specify which universal id type)
Note that if subcomponent 1 is populated, 2 and 3 should be empty. If subcomponent 2 is populated with an OID, subcomponent 3 must be populated with ISO.
Component 9-15: Facility address.
Components not specifically mentioned here are not expected in immunization messages.
RXA-15 Substance Lot Number (ST) 01129
Definition: This field contains the lot number of the medical substance administered. It may remain empty if the dose is from a historical record.
Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If two lot numbers are associated with a product that is a combination of different components, they may be included in this field. The first repetition should be the vaccine.
RXA-16 Substance Expiration Date (TS) 01130
Definition: This field contains the expiration date of the medical substance administered. It may remain empty if the dose is from a historical record.
Note: Vaccine expiration date does not always have a “day” component; therefore, such a date may be transmitted as YYYYMM.
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RXA-17 Substance Manufacturer Name (CE) 01131
Definition: This field contains the manufacturer of the medical substance administered.
Note: For vaccines, code system MVX should be used to code this field.
RXA-18 Substance/Treatment Refusal Reason (CE) 01136
Definition: This field contains the reason the patient refused the medical substance/treatment. Any entry in the field indicates that the patient did not take the substance. If this field is populated RXA-20, Completion Status shall be populated with RE.
RXA-20 Completion Status (ID) 01223
This field indicates if the dose was successfully given. It must be populated with RE if RXA-18 is populated with NA. If a dose was not completely administered or if the dose were not potent this field may be used to label the immunization. If this RXA has a CVX of 998 (no vaccine administered) then this shall be populated with NA.
RXA-21 Action Code – RXA (ID) 01224
This field indicates the action expected by the sending system. It can facilitate update or deletion of immunization records. This field has a usage of RE. If it is left empty, then receiving systems should assume that the action code is A.
ORC-3, Placer order number, may be used to link to a specific immunization if the system receiving the request has recorded this from the initial order. Local implementers should specify its’ use in a local implementation guide.
The action code U (Update system) is used to indicate to a subordinate receiver that a previously sent immunization should be changed. Most IIS have specific criteria for determining whether to add or update an immunization that does not rely directly on this field. For this reason it is common practice to indicate action as Add even if this vaccination has been previously reported. It is important to not assume that Updates will be or need to be specifically indicated.
RXA-22 System Entry Date/Time (TS) 01225
This field records the date/time that this record was created in the originating system. Local implementations should specify its’ use.
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Chapter 4—Data Types and Value Sets
Data types are the building blocks that are the foundation of successful interoperability. Each field, component or subcomponent has a data type. Conforming systems agree to adhere to the data type assigned to each component, assuring smooth communication. For example, dates may be formatted in many ways, but to assure interoperability, these need to be constrained and defined. HL7 specifies several formats, but these are compatible with each other. They allow dates to be as granular as needed. The format allows for just a year (YYYY) or for month, day, year, hour, minute, second, etc.
Data Types for IIS Use
Data types specify the format and type of data used. A data type may be as simple as a numeric data type, which allows a number. It may be a more complex coded entry that requires a specific set of code values and the name of the code system. Data types may contain subcomponents that are specified by data types.
The following list of data types only includes those that are used by fields that are anticipated for use by the MCIR project messages. Data types for fields that are not used in this Guide are not included, even if they are part of segment that is used.
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Table 0-1-- Data Types
Data type Data Type Name
CE Coded element
CQ Composite Quantity with Units
CWE Coded with Exceptions
CX Extended Composite Id with Check digit
EI Entity Identifier
ERL Error Location
FN Family Name
HD Hierarchic Designator
ID Coded Values for HL7 Tables
IS Coded value for User-Defined Tables
LA2 Location with address variation 2
MSG Message Type
NM Numeric
PT Processing Type
SAD Street Address
ST String
TS Time Stamp
VID Version Identifier
XAD Extended Address
XCN Extended Composite ID Number and Name for Persons
XPN Extended Person Name
XTN Extended telephone number
CE—Coded Element (most uses)
Definition: This data type transmits codes and the text associated with the code.
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Table 0-2 Coded Element (CE)
SEQ LEN Data Type Usage
Value Set
Component Name Comments
1 999 ST RE Identifier Identifying Code.
2 999 ST CE Text
Human readable text that is not further used. If Sequence 1 is populated, this should also be populated.
3 20 ID C 0396 Name of Coding
If sequence 1 is populated, this field must be populated.
4 999 ST RE Alternate Identifier
Alternate Identifying coded.
5 999 ST CE Alternate Text
Human readable text that is not further used. If Sequence 4 is populated, this should also be populated.
6 20 ID C 0396 Name of Alternate
If sequence 4 is populated, this field must be populated.
Note: Sequence 1, 2, and 3 are one triplet that are treated as a unit. The other triplet is a separate unit. Either may be populated, but should mean the same thing if both are populated.
The order of the contents is not specified. In the previous guide, the first triplet was reserved for CVX codes in RXA-5. This is no longer true, based on HL7 usage of CE data type.
Identifier (ST)
Definition: Sequence of characters (the code) that uniquely identifies the item being referenced. Different coding schemes will have different elements here.
Text (ST)
Definition: The descriptive or textual name of the identifier, e.g., DTaP. This is not used by the sending or receiving system, but rather facilitates human interpretation of the code.
Name of Coding System (ID)
Definition: Identifies the coding scheme being used in the identifier component. The combination of the identifier and name of coding system components will be a unique code for a data item. Each system has a unique identifier.
Alternate Identifier (ST)
Definition: An alternate sequence of characters (the code) that uniquely identifies the item being referenced. See usage note in section introduction.
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Alternate Text (ST)
Definition: The descriptive or textual name of the alternate identifier, e.g., DTaP. This is not used by the sending or receiving system, but rather facilitates human interpretation of the code.
Name of Alternate Coding System (ID)
Definition: Identifies the coding scheme being used in the alternate identifier component.
Example usage:
From RXA 5, Administered Code:
|50^DTAP-HIB^CVX^90721^DTAP-HIB^C4|
CQ—Composite Quantity with Units
Definition: This data type carries a quantity and attendant units. Its’ primary use in this Guide will be for indicating the maximum number of records to return in a query response.
Table 0-3 Composite Quantity with Units (CQ)
SEQ LEN
Data Type
Usage Value set
COMPONENT NAME
COMMENTS
1 16 NM R Quantity The value shall be a positive integer.
2 CE R 0126 Units The value shall be RD (records).
Maximum Length: 500
Note: CQ cannot be legally expressed when embedded within another data type. Its use is constrained to a segment field.
Examples:
|10^RD| 10 records
Quantity (NM)
Definition: This component specifies the numeric quantity or amount of an entity.
Units (CE)
Definition: This component species the units in which the quantity is expressed. Field-by-field, default units may be defined within the specifications. When the quantity is measured in the default units, the units need not be transmitted. If the quantity is recorded in units different from the default, the units must be transmitted.
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CWE—Coded With Exceptions
Definition: Specifies a coded element and its associated detail. The CWE data type is used when 1) more than one table may be applicable or 2) the specified HL7 or externally defined table may be extended with local values or 3) when text is in place, the code may be omitted.
Table 0-4 Coded with Exceptions (CWE)
SEQ LEN Data Type Usage
Value Set Component Name Comments
1 999 ST RE Identifier Identifying Code.
2 999 ST CE Text
Human readable text that is not further used. If Sequence 1 is populated, this should also be populated.
3 20 ID CE 0396 Name of Coding
If sequence 1 is populated, this field must be populated.
4 999 ST RE Alternate Identifier Alternate Identifying code.
5 999 ST CE Alternate Text
Human readable text that is not further used. If Sequence 4 is populated, this should also be populated.
6 20 ID CE 0396 Name of Alternate
If sequence 4 is populated, this field must be populated.
7 10 ST O Coding System Version Id
8 10 ST O Alternate Coding System Version Id
9 199 ST O Original Text
Note: Sequences 1, 2 and 3 are one triplet that are treated as a unit. The other triplet is a separate unit. Either may be populated, but should mean the same things if both are populated.
The order of the contents is not specified.
Identifier (ST)
Definition: Sequence of characters (the code) that uniquely identifies the item being referenced. Different coding schemes will have different elements here.
Text (ST)
Definition: The descriptive or textual name of the identifier, e.g., DTaP. This is not used by the sending or receiving system, but rather facilitates human interpretation of the code.
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Name of Coding System (ID)
Definition: Identifies the coding scheme being used in the identifier component. The combination of the identifier and name of coding system components will be a unique code for a data item. Each system has a unique identifier.
Alternate Identifier (ST)
Definition: An alternate sequence of characters (the code) that uniquely identifies the item being referenced. See usage note in section introduction.
Alternate Text (ST)
Definition: The descriptive or textual name of the alternate identifier, e.g., DTaP. This is not used by the sending or receiving system, but rather facilitates human interpretation of the code.
Name of Alternate Coding System (ID)
Definition: Identifies the coding scheme being used in the alternate identifier component.
Example usage:
From RXR: |C28161^IM^NCIT^IM^INTRAMUSCULAR^HL70162|
CX—Extended Composite ID with Check Digit
Table 0-5 Extended Composite ID with Check Digit (CX)
SEQ LEN
Data Type
Usage Value set
COMPONENT NAME
COMMENTS
1 15 ST R ID Number
2 1 ST O Check Digit
3 3 ID CE 0061 Check Digit Scheme
If sequence 2 is populated, then this sequence must be populated.
4 HD R 0363 Assigning Authority
5 5 ID R 0203 Identifier Type Code
6 HD O Assigning Facility
7 8 DT O Effective Date
8 8 DT O Expiration Date
9 CWE O Assigning Jurisdiction
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SEQ LEN
Data Type
Usage Value set
COMPONENT NAME
COMMENTS
10 CWE O Assigning Agency or Department
Definition: This data type is used for specifying an identifier with its associated administrative detail.
Maximum Length: 1913
Note: The check digit and check digit scheme are empty if ID is alphanumeric.
Example:
|1234567^^^ME129^MR|
ID (ST)
Definition: The value of the identifier itself.
Check Digit (ST)
This component should be valued empty.
Check Digit Scheme (ID)
This component should be valued if Check digit is populate, otherwise it should be empty.
Assigning Authority (HD)
The assigning authority is a unique name of the system (or organization or agency or department) that creates the data. . Refer to User-defined Table 0363 – Assigning authority for suggested values. This table shall be maintained by each IIS. The first component shall be used for this unique name. The second and third may be used if OIDs9 are recorded.
Identifier Type Code (ID)
A code corresponding to the type of identifier. In some cases, this code may be used as a qualifier to the “Assigning authority” component. Refer to HL7 Table 0203 - Identifier type for suggested values.
DT—Date
Definition: Specifies the century and year with optional precision to month and day.
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Table 0-6 Date (DT)
SEQ LEN
Data
Type Usage Value Set
Component Name Comments
1 8 R Date
As of v 2.3, the number of digits populated specifies the precision using the format specification YYYY(MM[DD]). Thus:
Four digits are used to specify a precision of “year”
Six are used to specify a precision of “month”
Eight are used to specify a precision of “day.”
Examples:
|19880704|
|199503|
|2000|
DTM—Date/Time
Table 0-7 Date/Time (DTM)
SEQ LEN
Data
Type Usage Value Set
Component Name Comments
24 R Date/time
The number of characters populated (excluding the time zone specification) specifies the precision.
Format: YYYY[MM[DD[HH[MM[SS[.S[S[S[S]]]]]]]]][+/-ZZZZ].
Thus:
Four digits are used to specify a precision of “year”
Six are used to specify a precision of “month”
Eight are used to specify a precision of “day.”
the first ten are used to specify a precision of “hour”
the first twelve are used to specify a precision of “minute”
the first fourteen are used to specify a precision of “second”
the first sixteen are used to specify a precision of “one tenth of a second”
the first nineteen are used to specify a precision of “ one ten thousandths of a second”
When the time zone is not included, it is presumed to be the time zone of the sender.
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Example: |199904| specifies April 1999.
EI—Entity Identifier
Definition: The entity identifier defines a given entity within a specified series of identifiers.
Table 0-8 Entity Identifier (EI)
SEQ LEN
Data Type
Usage
Value Set
COMPONENT NAME
COMMENTS
1 199 ST RE Entity Identifier
2 20 IS C 0363 Namespace ID If Universal Id is not populated, then this field shall be populated.
3 199 ST CE Universal ID If Namespace ID is not populated, then this field shall be populated. When populated, it shall be an OID.
4 6 ID C 0301 Universal ID Type
If Universal Id is populated, this field must also be populated. When populated, it shall be constrained to ISO.
Maximum Length: 427
Entity Identifier (ST)
The first component, <entity identifier>, is defined to be unique within the series of identifiers created by the <assigning authority>, defined by a hierarchic designator, represented by component 2.
Namespace ID (IS)
The assigning authority is a unique identifier of the system (or organization or agency or department) that creates the data. Refer to User-defined Table 0363 – Assigning authority for suggested values.
Universal ID (ST)
This is a universal id associated with this entity. It must be linked to the Universal Id Type below. If populated, it shall be an OID.
Universal ID Type (ID)
This universal id type is drawn from HL7 Table 0301. If populated, it shall be ISO.
Example:
From MSH 21 profile identifier:
|Z44^CDCPHINVS|
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ERL—Error Location
Table 0-9 Error Location (ERL)
Definition: This data type identifies the segment and its constituent where an error has occurred.
Maximum Length: 18
Segment ID (ST)
Definition: Specifies the 3-letter name for the segment.
Segment Sequence (NM)
Definition: Identifies the segment occurrence within the message. That is, for the first instance of the segment in the message the number shall be 1.
Field Position (NM)
Definition: Identifies the number of the field within the segment. The first field is assigned a number of 1. Field number should not be specified when referring to the entire segment.
SEQ LEN
Data Type
Usage Value Set COMPONENT NAME
COMMENTS
1 3 ST R Segment ID The 3-character name for the segment (i.e. PID)
2 2 NM R Segment Sequence
3 2 NM RE Field Position This should not be populated if the error refers to the whole segment.
4 2 NM RE Field Repetition This should be populated whenever Field Position is populated.
5 2 NM RE Component Number
Should be populated ONLY when a particular component cause the error.
6 2 NM RE Sub-Component Number
Should be populated ONLY when a particular sub-component cause the error.
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Field Repetition (NM)
Definition: Identifies the repetition number of the field. The first repetition is counted as 1. If a Field Position is specified, but Field Repetition is not, Field Repetition should be assumed to be 1. If Field Position is not specified, Field Repetition should not be specified.
Component Number (NM)
Definition: Identifies the number of the component within the field. The first component is assigned a number of 1. Component number should not be specified when referring to the entire field.
Sub-Component Number (NM)
Definition: Identifies the number of the sub-component within the component. The first sub-component is assigned a number of 1. Sub-component number should not be specified when referring to the entire component.
Example:
|RXA^1^5^1^3|
FN—Family Name
Definition: This data type contains a person’s family name or surname.
Table 0-10 Family Name
SEQ LEN
Data Type
Usage Value Set
COMPONENT NAME COMMENTS
1 50 ST R Surname
2 20 ST O Own Surname Prefix
3 50 ST O Own Surname
4 20 ST O Surname Prefix From Partner/Spouse
5 50 ST O Surname From Partner/Spouse
Surname (ST)
This is the person’s last name.
Example from PID: |Anyperson|
HD—Hierarchic Designator
Definition: HD identifies an (administrative or system or application or other) entity that has responsibility for managing or assigning a defined set of instance identifiers (such as placer or filler number, patient identifiers, provider identifiers, etc.). This entity could be
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a particular health care application such as a registration system that assigns patient identifiers, a governmental entity such as a licensing authority that assigns professional identifiers or drivers’ license numbers, or a facility where such identifiers are assigned.
Table 0-11 Hierarchical Designator (HD)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME
COMMENTS
1 20 IS CE 0300
0361
0362
0363
Namespace ID This field is used for a locally defined name/id. It may be used as previous version 2.3.1 Implementation Guide specified. If the field or component is required, then this field shall be populated if components 2 and 3 are not populated. The value set used depends on usage.
2 199 ST CE Universal ID This field shall be populated if component 3 is populated. This field must be populated if field 1 is empty. This field shall use OID if populated
3 6 ID CE 0301 Universal ID Type
This field shall be populated if component 2 is populated. If populated the value is constrained to ISO
IS—Namespace ID
User-defined Table 0300/0361/0362/0363 - Namespace ID is used as the HL7 identifier for the user-defined table of values for this component.
Note: When the HD is used in a given segment (either as a field or as a component of another data type) this table may be re-defined (given a different user-defined table number and name) by the technical committee responsible for that segment.
Tables 0361-0363 are preferred for most instances. For instance for identifying the assigning authority, use 0363.
Universal ID (ST)
The HD’s second component, <universal ID> (UID), is a string formatted according to the scheme defined by the third component, <universal ID type> (UID type). The UID is intended to be unique over time within the UID type. It is rigorously defined. Each UID must belong to one of the specifically enumerated schemes for constructing UIDs
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(defined by the UID type). The UID (second component) must follow the syntactic rules of the particular universal identifier scheme (defined by the third component). Note that these syntactic rules are not defined within HL7 but are defined by the rules of the particular universal identifier scheme (defined by the third component).
Universal ID Type (ID)
The third component governs the interpretation of the second component of the HD. If the third component is a known UID refer to HL7 Table 0301 - Universal ID type for valid values, then the second component is a universal ID of that type. Since the second component is constrained to OID, then the value of component 3 shall be ISO, when populated.
Example from MSH:
|CA12^^|
ID—Coded Values for HL7 Tables
Definition: This data type is used for coded values from an HL7 table.
The value of such a field follows the formatting rules for an ST field except that it is drawn from a table of legal values. There shall be an HL7 table number associated with ID data types. An example of an ID field is PID 24 –Multiple Birth Indicator. This data type should be used only for HL7 tables (see Appendix A).
Example from PID Multiple Birth Indicator:
|Y|
IS—Coded Values for User Defined Tables
Definition: This data type is used for codes from User-defined Tables.
Table 0-12 Coded Values for User Defined Tables (IS)
SEQ Length
Data Type
Usage Value Sets COMPONENT NAME COMMENTS
20
(Max.)
Coded Value for User-Defined Tables
Maximum Length: 20
The value of such a field follows the formatting rules for a ST field except that it is drawn from a site-defined (or user-defined) table of legal values. There shall be an HL7 table number associated with IS data types. This data type should be used only for user-defined tables (see Section 2.5.3.6 - Table).
Example from PID Sex:
|F|
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LA2 -- Location with Address Variation 2
Definition: Specifies a location and its address.
Table 0-13 Location with Address Variation 2
SEQ LEN Data Type
Usage Value Sets
COMPONENT NAME
COMMENTS
1 20 IS O 0302 Point of Care This represents the location within a facility that the service was provided. This is not the clinic site where an event occurred.
2 20 IS O 0303 Room
3 20 IS O 0304 Bed
4 HD RE Facility This represents the location that the service was provided. For example the clinic.
5 20 IS O 0306 Location Status
6 20 IS O 0305 Patient Location Type
7 20 IS O 0307 Building
8 20 IS O 0308 Floor
9 120 ST O Street Address
10 120 ST O Other Designation
11 50 ST O City
12 50 ST O State or Province
13 12 ST O Zip or Postal Code
14 3 ID O 0399 Country
15 3 ID O 0190 Address Type
16 50 ST O Other Geographic Designation
Maximum Length: 790
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Note: Replaces the CM data type used in 4.14.5.13 RXD-13, 4.14.6.11 RXG-11 and 4.14.7.11 RXA-11 as of V 2.5.
MSG—Message Type
Definition: This field contains the message type, trigger event, and the message structure ID for the message.
Table 0-14 Message Type (MSG)
SEQ LEN Data Type
Usage Value Set COMPONENT NAME COMMENTS
1 3 ID R 0076 Message Code
2 3 ID R 0003 Trigger Event
3 7 ID R 0354 Message Structure
Maximum Length: 15.
Note: Replaces the CM data type used in 2.16.9.9 MSH-9 as of v 2.5.
Message Code (ID)
Definition: Specifies the message type code. Refer to HL7 Table – Message Type in section 2.17.1 for valid values.
This table contains values such as ACK, ADT, ORU etc.
See section 2.5.1- Messages for further discussion.
Trigger Event (ID)
Definition: Specifies the trigger event code. Refer to HL7 Table – Event Type in section 2.17.2 for valid values.
This table contains values like A01, V01, R01 etc.
Message Structure (ID)
Definition: Specifies the abstract message structure code. Refer to HL7 Table 0354.
Example from MSH:
|VXU^V04^VXU_V04|
NM—Numeric
Definition: A number represented as a series of ASCII numeric characters consisting of an optional leading sign (+ or -), the digits and an optional decimal point. In the absence of a sign, the number is assumed to be positive. If there is no decimal point the number is assumed to be an integer.
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Table 0-15 Numeric (NM)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
16 Numeric
Maximum Length: 16
Examples:
|999|
|-123.792|
Leading zero’s, or trailing zero’s after a decimal point, are not significant. For example, the following two values with different representations, “01.20” and “1.2,” are identical. Except for the optional leading sign (+ or -) and the optional decimal point (.), no non-numeric ASCII characters are allowed. Thus, the value <12 should be encoded as a structured numeric (SN) (preferred) or as a string (ST) (allowed, but not preferred) data type.
PT—Processing Type
Definition: This data type indicates whether to process a message as defined in HL7 Application (level 7) Processing rules.
Table 0-16 Processing Type (PT)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
1 1 ID R 0103 Processing ID
2 1 ID X 0207 Processing Mode Constrain to empty, which implies current processing.
Maximum Length: 3
Processing ID (ID)
A value that defines whether the message is part of a production, training, or debugging system. Refer to HL7 Table 0103 - Processing ID for valid values.
SAD—Street Address
Definition: This data type specifies an entity’s street address and associated detail.
Table 0-17 Street Address (SAD)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
1 120 ST R Street or Mailing Address
2 50 ST O Street Name
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SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
3 12 ST O Dwelling Number
Maximum Length: 184
Note: Appears ONLY in the XAD data type
Street or Mailing Address (ST)
Definition: This component specifies the street or mailing address of a person or institution.
SI—Sequence Id
Definition: A non-negative integer in the form of a NM field. The uses of this data type are defined in the chapters defining the segments and messages in which it appears.
Table 0-18 Sequence Id (SI)
SEQ LEN Data Type
Usage Value set
COMPONENT NAME COMMENTS
4 Sequence ID
Maximum Length: 4.This allows for a number between 0 and 9999 to be specified.
TS—Time Stamp
Definition: Specifies a point in time.
Table 0-19 Time Stamp (TS)
SEQ LEN Data Type
Usage Value Set COMPONENT NAME
COMMENTS
1 24 DTM R Time
2 1 ID X 0529 Degree of Precision
Maximum Length: 26
Time (DTM)
Definition: The point in time.
VID—Version Id
Definition: This specifies the HL7 version.
Table 0-20 Version ID (VID)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME
COMMENTS
1 5 ID R 0104 Version ID
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SEQ LEN Data Type
Usage Value Set
COMPONENT NAME
COMMENTS
2 CE O 0399 Internationalization Code
3 CE O International Version ID
Maximum Length: 973
Version ID (ID)
Used to identify the HL7 version. Refer to HL7 Table 0104 – Version ID in section 2.15.9.12 for valid values.
XAD—Extended Address
Definition: This data type specifies the address of a person, place or organization plus associated information.
Table 0-21 Extended Address (XAD)
SEQ LEN Data Type
Usage Value Sets
COMPONENT NAME COMMENTS
1 SAD RE Street Address
2 120 ST RE Other Designation
3 50 ST RE City
4 50 ST RE State or Province
5 12 ST RE Zip or Postal Code
6 3 ID O 0399 Country Empty defaults to USA
7 3 ID R 0190 Address Type
8 50 ST O Other Geographic Designation
9 20 IS O 0289 County/Parish Code
10 20 IS O 0288 Census Tract
11 1 ID O 0465 Address Representation Code
12 DR X Address Validity Range deprecated as of v 2.5
13 TS O Effective Date
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SEQ LEN Data Type
Usage Value Sets
COMPONENT NAME COMMENTS
14 TS O Expiration Date
Maximum Length: 631
Example of usage for US:
|1000 Hospital Lane^Ste. 123^Ann Arbor ^MI^99999^^B|
This would be formatted for postal purposes as
1000 Hospital Lane
Ste. 123
Ann Arbor MI 99999
Street Address (SAD)
Definition: This is the street address.
Other Designation (ST)
Definition: Second line of address. In US usage, it qualifies address. Examples: Suite 555 or Fourth Floor. This can be used for dwelling number.
City (ST)
Definition: This component specifies the city, or district or place where the addressee is located depending upon the national convention for formatting addresses for postal usage.
State or Province (ST)
Definition: This component specifies the state or province where the addressee is located. State or province should be represented by the official postal service codes for that country.
Zip or Postal Code (ST)
Definition: This component specifies the zip or postal code where the addressee is located. Zip or postal codes should be represented by the official codes for that country. In the US, the zip code takes the form 99999[-9999], while the Canadian postal code takes the form A9A9A9, and the Australian Postcode takes the form 9999.
Country (ID)
Definition: This component specifies the country where the addressee is located. HL7 specifies that the 3-character (alphabetic) form of ISO 3166 be used for the country code. Refer to HL7 Table 0399 – Country code in section 2.15.9.17 for valid values.
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Address Type (ID)
Definition: This component specifies the kind or type of address. Refer to HL7 Table 0190 - Address type for valid values.
County/Parish Code (IS)
A code that represents the county in which the specified address resides. User-defined Table 0289 - County/parish is used as the HL7 identifier for the user-defined table of values for this component. When this component is used to represent the county (or parish), component 8 <other geographic designation> should not duplicate it (i.e., the use of <other geographic designation> to represent the county is allowed only for the purpose of backward compatibility, and should be discouraged in this and future versions of HL7).
Allowable values: codes defined by government.
Effective Date (TS)
Definition: The first date, if known, on which the address is valid and active.
Expiration Date (TS)
Definition: The last date, if known, on which the address is valid and active.
XCN - Extended Composite ID Number and Name for Persons
Definition: This data type identifies a person using a unique id and name. The ID is associated with an entity such as an organization, which assigns the ID.
Table 0-22 Extended Composite ID Number and Name (XCN)
SEQ LEN DT Usage TBL# COMPONENT NAME
COMMENTS
1 15 ST C ID Number If name fields below are not populated, then this field must be populated.
2 FN RE Family Name
3 30 ST RE Given Name
4 30 ST RE Second and Further Given Names or Initials Thereof
5 20 ST O Suffix (e.g., JR or III)
6 20 ST O Prefix (e.g., DR)
7 5 IS X 0360
Degree (e.g., MD) Use Professional suffix in sequence 21.
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SEQ LEN DT Usage TBL# COMPONENT NAME
COMMENTS
8 4 IS O 0297
Source Table Since we are requiring assigning authority, this field may be left empty.
9 HD C 0363
Assigning Authority If the id field is populated, then this field must be populated.
10 1 ID O 0200
Name Type Code If the name fields are populated and this is empty, then the type defaults to L, legal name.
11 1 ST O Identifier Check Digit
12 3 ID C 0061
Check Digit Scheme If check digit identifier is populated, then this field must indicate the check digit scheme.
13 5 ID O 0203
Identifier Type Code Constrain to values in the published HL7 table 0203 only.
14 HD O Assigning Facility
15 1 ID O 0465
Name Representation Code
16 CE O 0448
Name Context
17 DR X Name Validity Range
18 1 ID X 0444
Name Assembly Order
19 TS O Effective Date
20 TS O Expiration Date
21 ST O Professional Suffix
22 CWE
O Assigning Jurisdiction
23 CWE
O Assigning Agency or Department
Maximum Length: 3002
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This data type is used where there is a need to specify the ID number and name of a person.
ID number (ST)
This string refers to the coded ID assigned by the assigning authority.
Family Name (FN)
This component contains the person’s surname.
Given Name (ST)
First name.
Second and Further Given Names or Initials Thereof (ST)
Multiple middle names may be included by separating them with spaces.
Suffix (ST)
Used to specify a name suffix (e.g., Jr. or III).
Prefix (ST)
Used to specify a name prefix (e.g., Dr.).
Source Table (IS)
User-defined Table 0297 – CN ID source is used as the HL7 identifier for the user-defined table of values for this component. Used to delineate the first component.
Assigning Authority (HD)
The assigning authority is a unique identifier of the system (or organization or agency of department) that creates the data. User-defined Table 0363 – Assigning authority is used as the HL7 identifier for the user-defined table of values for the first sub-component of the HD component, <namespace ID>.
Note: When HD data type is used as a component of another data type, its components are demoted to subcomponents. This means that each component is separated by & rather than ^. For example:
Name space id^some OID^ISO becomes Name space id&some OID&^ISO
Note: When the HD data type is used in a given segment as a component of a field of another data type, User-defined Table 0300 - Namespace ID (referenced by the first sub-component of the HD component) may be re-defined (given a different user-defined table number and name) by the technical committee responsible for that segment. User-defined Table 0363 is specified by this Implementation Guide for Assigning Authority.
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By site agreement, implementers may continue to use User-defined Table 0300 – Namespace ID for the first sub-component.
Name Type Code (ID)
A code that represents the type of name. Refer to HL7 Table 0200 - Name type for valid values. If the field is not populated then the value is assumed to be L.
Identifier Check Digit (ST)
The check digit in this data type is not an add-on produced by the message processor. It is the check digit that is part of the identifying number used in the sending application. If the sending application does not include a self-generated check digit in the identifying number, this component should be valued empty.
Check Digit Scheme (ID)
Definition: Contains the code identifying the check digit scheme employed.
Refer to HL7 Table 0061 - Check digit scheme for valid values.
Identifier Type Code (IS)
A code corresponding to the type of identifier. In some cases, this code may be used as a qualifier to the <assigning authority> component. Refer to HL7 Table 0203 - Identifier type for suggested values.
Professional Suffix (ST)
Definition: Used to specify an abbreviation, or a string of abbreviations denoting qualifications that support the person’s profession, (e.g., licenses, certificates, degrees, affiliations with professional societies, etc.). The Professional Suffix normally follows the Family Name when the Person Name is used for display purposes. Please note that this component is an unformatted string and is used for display purposes only.
Extended Person Name (XPN)
Definition: This is used for representing a person’s name.
Table 0-23 Extended Person Name (XPN)
SEQ LEN Data Type
Usage Value Sets
COMPONENT NAME COMMENTS
1 FN R Family Name
2 30 ST R Given Name
3 30 ST RE Second and Further Given Names or Initials Thereof
4 20 ST O Suffix (e.g., JR or III)
5 20 ST O Prefix (e.g., DR)
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SEQ LEN Data Type
Usage Value Sets
COMPONENT NAME COMMENTS
6 6 IS X 0360 Degree (e.g., MD) Use Professional suffix in sequence 14
7 1 ID RE 0200 Name Type Code
8 1 ID O 0465 Name Representation Code
9 CE O 0448 Name Context
10 DR X Name Validity Range
11 1 ID O 0444 Name Assembly Order
12 TS O Effective Date
13 TS O Expiration Date
14 199 ST O Professional Suffix
Maximum Length: 1103
Note: Replaces PN data type as of v 2.3.
Family Name (FN)
This is the person’s surname or family name.
Given Name (ST)
First name.
Second and Further Given Names or Initials Thereof (ST)
Multiple middle names may be included by separating them with spaces.
Suffix (ST)
Used to specify a name suffix (e.g., Jr. or III).
Prefix (ST)
Used to specify a name prefix (e.g., Dr.).
Name Type Code (ID)
A code that represents the type of name. Refer to HL7 Table 0200 - Name type for valid values.
Note: The content of Legal Name is country specific. In the US the legal name is the same as the current married name.
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Professional Suffix (ST)
This is the person’s professional suffix. Replaces degree above.
XTN - Extended Telecommunication Number
Definition: This contains the extended telephone number.
Table 0-24 XTN Extended Telecommunication Number (XTN)
SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
1 199 ST X Telephone Number Deprecated as of 2.3
2 3 ID R 0201 Telecommunication Use Code
3 8 ID RE 0202 Telecommunication Equipment Type
4 199 ST CE Email Address If the telecommunication type code is NET, then this field shall be populated.
5 3
NM O Country Code
6 5 NM CE Area/City Code If the telecommunication type code is not NET, then this field shall be populated.
7 9 NM CE Local Number If the telecommunication type code is not NET, then this field shall be populated.
8 5 NM O Extension
9 199 ST O Any Text
10 4 ST O Extension Prefix
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SEQ LEN Data Type
Usage Value Set
COMPONENT NAME COMMENTS
11 6 ST O Speed Dial Code
12 199 ST O Unformatted Telephone number
Maximum Length: 850
Note: Components five through nine reiterate the basic function of the first component in a delimited form that allows the expression of both local and international telephone numbers. As of 2.3, the recommended form for the telephone number is to use the delimited form rather than the unstructured form supported by the first component .The old implementation guide (2.3.1) allowed the first component to be used for phone number. This is not supported by this Guide.
Note: Replaces TN data type as of v 2.3
Example: A primary residence number
^PRN^PH^^^734^6777777
Telecommunication Use Code (ID)
A code that represents a specific use of a telecommunication number. Refer to HL7 Table 0201 - Telecommunication use code for valid values.
Telecommunication Equipment Type (ID)
A code that represents the type of telecommunication equipment. Refer to HL7 Table 0202 - Telecommunication equipment type for valid values.
Email Address (ST)
The email address for the entity.
Area/city Code (NM)
The telephone area code for the entity.
Phone Number (NM)
The phone number for the entity Extension (NM)
The extension to the phone.
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Chapter 5—Code Tables
NOTE: Where only selected values are listed for HL7 tables, please refer to the HL7 Standard for complete listings. In this appendix, values are selected from standard code sets where available. The Value Sets are maintained in the PHIN VADS for use in Public Health. The main purpose of PHIN VADS is to distribute vocabulary subsets needed in Public Health. The latest version of value sets referenced in this Implementation Guide can be obtained from PHIN VADS at (http://phinvads.cdc.gov ). Search using keyword “immunization”.
This material contains content from LOINC® (http://loinc.org). The LOINC table and LOINC codes are copyright © 1995-2010, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee.
This material contains content from SNOMED CT. SNOMED CT (Systematized Nomenclature of Medicine—Clinical Terms) is a comprehensive clinical terminology, originally created by the College of American Pathologists (CAP) and, as of April 2007, owned, maintained, and distributed by the International Health Terminology Standards Development Organization (IHTSDO), a non-for-profit association in Denmark. The CAP continues to support SNOMED CT operations under contract to the IHTSDO and provides SNOMED-related products and services as a licensee of the terminology.
User-defined Table 0001 - Sex
This code reflects the self-reported gender. Use in PID-8, NK1-15 Value set OID: 2.16.840.1.113883.1.11.1
Value
Description
Definition
F Female Person reports that she is female.
M Male Person reports that he is male.
U Unknown/undifferentiated No assertion Is made about the gender of the person.
HL7-defined Table 0003 - Event type
Only selected values listed Use in MSH-9, second component This code indicates the trigger event. Refer to Chapter 3, Version 2.5.1 for further information on HL7 event triggers.
Value
Description
A28 ADT/ACK - Add person information
A08 ADT/ACK – Update person information
A04 ADT/ACK – Register a patient
Q11 QBP - Query by parameter requesting an RSP segment pattern response (Query for vaccination record)
K11 RSP - Segment pattern response in response to QBP^Q11 (Response to vaccination query)
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V04 VXU - Unsolicited vaccination record update
User-defined Table 0004 - Patient class
Use in PV1-2.
This code categorizes the patient in the current event. The only value supported is R for recurring patient. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
User-defined Table 0005 – Race
These values are consistent with the OMB Notice of revised categories for collection of race and ethnicity data—the combined format. Use in PID-10, NK1-35.
This code represents the client’s self-reported race.
Value set OID: 2.16.840.1.114222.4.11.836 US race codes
Description
1002-5 American Indian or Alaska Native
2028-9 Asian
2076-8 Native Hawaiian or Other Pacific Islander
2054-5 Black or African-American
2106-3 White
2131-1 Other Race
<empty field> Unknown/undetermined
The following table is included for reference. The NIP original race codes are still accepted for backwards compatibility. The numeric code US race codes should be used.
US race codes
Description
NIP original race codes
Description
1002-5 American Indian or Alaska Native
I American Indian or Alaska Native
2028-9 Asian A Asian or Pacific Islander
2076-8 Native Hawaiian or Other Pacific Islander
A Asian or Pacific Islander
2054-5 Black or African-American B Black or African-American
2106-3 White W White
2131-1 Other Race O Other
Unknown U Unknown
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HL7-defined Table 0008 - Acknowledgment code
Use in MSA-1.
This code indicates the type of acknowledgement expected. Value
Description
AA Original mode: Application Accept Enhanced mode: Application acknowledgment: Accept
AE Original mode: Application Error Enhanced mode: Application acknowledgment: Error
AR Original mode: Application Reject Enhanced mode: Application acknowledgment: Reject
CA Enhanced mode: Accept acknowledgment: Commit Accept
CE Enhanced mode: Accept acknowledgment: Commit Error
CR Enhanced mode: Accept acknowledgment: Commit Reject
User-defined Table 0010 - Physician ID
Use in all XCN data types; including PV1-7, 8,9,17, RXA-10.
Each registry should establish a system of coding its reporting physicians. The National Provider Identifier (NPI) adopted for the HIPAA legislation may be used for this purpose.
HL7-defined Table 0061 - Check digit scheme
Use in all CX data types; including PID-2, 3, 4, 18, 21. Value
Description
M10 Mod 10 algorithm
M11 Mod 11 algorithm
ISO ISO 7064: 1983
NPI Check digit algorithm in the US National Provider Identifier
User-defined Table 0063 – Relationship
Use in NK1-3, IN1-17 Value
Description
BRO Brother
CGV Care giver
FCH Foster child
FTH Father
GRD Guardian
GRP Grandparent
MTH Mother
OTH Other
PAR Parent
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Value
Description
SCH Stepchild
SEL Self
SIB Sibling
SIS Sister
SPO Spouse
User-defined Table 0064 - Financial class
Use in OBX-5 for client eligibility for a funding program at the dose administered level.
Financial class references a client’s eligibility status at the time of vaccine administration. It is the eligibility of the client for the vaccine administered. The values in this table relate to eligibility for the Vaccine for Children (VFC) program.
Local implementations may define and document local codes. Each state immunization program may have locally specified funding programs for immunizations. In order to assure that each is unique across states, codes should be created that begin with the grantee assigning authority code from table 0363 in the Implementation Guide for Immunization Messaging, release 1.3. This would be followed by sequential number, left padded to a length of 2. For example if Alaska had a funding program, they would create a code of AKA01 for the first program. It is incumbent on the state or other jurisdiction to clearly describe the requirements that qualify a person for that funding program. For instance if the hypothetical funding program in Alaska covered people who were too old for VFC program but would otherwise qualify because they were Medicaid eligible, then they would define the code as:
“Client is currently on MEDICAID and is older than 19 years old.”
Note that funding source for a specific immunization is different from client eligibility for funding program (Financial Class).
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Code Label Definition
V01 Not VFC eligible Client does not qualify for VFC because they do not have one of the statuses below. (V02-V05)
V02 VFC eligible-Medicaid/Medicaid Managed Care
Client is currently on Medicaid or Medicaid managed care and < 19 years old and the vaccine administered is eligible for VFC funding.
V03 VFC eligible- Uninsured Client does not have private insurance coverage and < 19 years old and the vaccine administered is eligible for VFC funding.
V04 VFC eligible- American Indian/Alaskan Native
Client is a member of a federally recognized tribe and < 19 years old and the vaccine administered is eligible for VFC funding.
V05 VFC eligible-Federally Qualified Health Center Patient (under-insured)
Client has insurance, but insurance does not cover vaccines, limits the vaccines covered, or caps vaccine coverage at a certain amount and so client is eligible for VFC coverage at a Federally Qualified Health Center. The client must be receiving the immunizations at the FQHC or a FQHC designated clinic and < 19 years old and the vaccine administered is eligible for VFC funding.
V06 Deprecated [VFC eligible- State specific eligibility (e.g. S-CHIP plan)]
Do not use this code. State specific funding should either use V07 or a state generated code.
V07 Local-specific eligibility Client is eligible for state supplied vaccine based on local specific rules and the vaccine administered is eligible for state- funding. It should only be used if the state has not published local codes for these programs.
V08 Deprecated [Not VFC eligible-underinsured]
Do not use this code. The MIROW effort determined that persons in this situation are V01, not VFC eligible. It is not necessary to differentiate this sub-class of Not VFC eligible.
HL7-defined Table 0076 - Message type
Only selected values listed. Use in MSH-9, first component.
Value
Description Usage in this guide
ACK General acknowledgment Supported
ADT ADT message Supported
QBP Query by Parameter Supported
RSP Response to Query by parameter Supported
VXU Unsolicited vaccination record update Supported
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HL7-defined Table 0078 - Abnormal flags
Use in OBX-8.
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0085 - Observation result status codes interpretation
Use in OBX-11.
Fields using this code set are expected to be F for Final. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0091 - Query priority
Fields using this code set are expected to be I or empty, which indicates Immediate processing is expected. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0102 - Delayed acknowledgment type
Use in MSA-5.
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0103 - Processing ID
Use in MSH-11.
Value Description
D Debugging
P Production
T Training
HL7-defined Table 0104 - Version ID
Use in MSH-12.
Value Description
2.1 Release 2.1
2.2 Release 2.2
2.3 Release 2.3 March 1997
2.3.1 Release 2.3.1 May 1999
2.4 Release 2.4 October 2000
2.5.1 Release 2.5.1 April 2007
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HL7-defined Table 0105 - Source of comment
Use in NTE-2.
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0119 – Order Control Codes
Use in ORC-1.
Value
Description Usage
OK Order accepted & OK Not supported
RE Observations to follow Supported
HL7-defined Table 0126 - Quantity limited request
Use in RCP-2.
Fields using this code set are expected to be set to RD for records. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0136 - Yes/No indicator
Use in PID-24,30; PD1-12
Value Description
Y Yes
N No
In fields that may be empty, such as PD1-12 no value should be entered if the value is not Y or N. In HL7 “” means remove the previous value. If the field is empty, then it means do nothing to existing values.
Value in Field Meaning
“”
|””|
Nullify the value recorded in the receiving system data base.
<empty field>
||
Make no changes to the record in the receiving data base. The sending system has no information on this field.
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HL7-defined Table 0155 - Accept/Application acknowledgment conditions
Use in MSH-15 and 16
Value Description
AL Always
NE Never
ER Error/Reject conditions only
SU Successful completion only
HL7-defined Table 0162 - Route of administration
Only selected values included. Use in RXR-1.
FDA NCI Thesaurus (NCIT)
HL7-0162 Description Definition
C38238
ID Intradermal within or introduced between the layers of the skin
C28161
IM Intramuscular within or into the substance of a muscle
C38284
NS Nasal Given by nose
IN Intranasal {Do not use this older code}
C38276
IV Intravenous administered into a vein
C38288
PO Oral administered by mouth
OTH Other/Miscellaneous
C38676
Percutaneous made, done, or effected through the skin.
C38299
SC Subcutaneous Under the skin or between skin and muscles.
C38305
TD Transdermal describes something, especially a drug, that is introduced into the body through the skin
Example
|C28161^Intramuscular^NCIT|
|SC^Subcutaneous^HL70162|
HL7-defined Table 0163 - Administrative site
Only selected values listed. Use in RXR-2.
HITSP has recommended the use of SNOMED codes. At this point not all of these concepts have pre-coordinated SNOMED codes. The post-coordinated are longer than the nominal length of the first component of the CE data type. Therefore, this guide will continue to support the HL7 0163 codes.
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SNOMED HL7 0163
Description
LT Left Thigh
LA Left Arm
LD Left Deltoid
LG Left Gluteous Medius
LVL Left Vastus Lateralis
LLFA Left Lower Forearm
RA Right Arm
RT Right Thigh
RVL Right Vastus Lateralis
RG Right Gluteous Medius
RD Right Deltoid
RLFA Right Lower Forearm
User-defined Table 0189 - Ethnic Group
These values are consistent with the OMB Notice of revised categories for collection of race and ethnicity data and with HL7’s Version 2.4 Use in PID-22, NK1-28.
US ethnicity codes
HL7 Version 2.4 ethnicity codes
Description
2135-2 H Hispanic or Latino
2186-5 N not Hispanic or Latino
U Unknown
HL7-defined Table 0190 - Address type
use in all XAD data types; including PID-11)
Value Description
C Current or temporary
P Permanent
M Mailing
B Firm/Business
O Office
H Home
N Birth (nee)
F Country of origin
L Legal address
BDL Birth delivery location [use for birth facility]
BR Residence at birth [use for residence at birth]
RH Registry home
BA Bad address
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HL7-defined Table 0200 - Name type
Use in all XCN, XPN data types; including PID-5, 6, 9
Value Description
Definition
A Alias name This is a nickname or other assumed name.
L Legal name This is a person’s official name. It is the primary name recorded in the IIS.
D Display name This is the preferred name displayed on a user interface.
M Maiden name This is a woman’s name before marriage.
C Adopted name This is the name of a person after adoption.
B Name at birth This is name recorded at birth (prior to adoption).
P Name of partner/spouse This is the name of the partner or spouse.
U Unspecified This is a name of unspecified type.
HL7-defined Table 0201 - Telecommunication use code
Use in all XTN data types including PID-13,14.
Value Description
PRN Primary residence number
ORN Other residence number
WPN Work number
VHN Vacation home number
ASN Answering service number
EMR Emergency number
NET Network (email) address
BPN Beeper number
HL7-defined Table 0202 - Telecommunication equipment type
Use in all XTN data types; including PID-13,14
Value
Description
PH Telephone
FX Fax
MD Modem
CP Cellular phone
BP Beeper
Internet Internet address: Use only if telecommunication use code is NET
X.400 X.400 email address: Use only if telecommunication use code is NET
TDD Telecommunications Device for the Deaf
TTY Teletypewriter
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User-defined Table 0203 - Identifier type
Values suggested by HL7; with CDC-suggested additions. Use in all CX, XCN type codes; including PID-2, 3, 4, 18, 21 and RXA-10
HL7 Table 0203 - Identifier type
Value Description Comment
AN Account number An identifier that is unique to an account.
ANON Anonymous identifier An identifier for a living subject whose real identity is protected or suppressed
Justification: For public health reporting purposes, anonymous identifiers are occasionally used for protecting patient identity in reporting certain results. For instance, a state health department may choose to use a scheme for generating an anonymous identifier for reporting a patient that has had a positive human immunodeficiency virus antibody test. Anonymous identifiers can be used in PID 3 by replacing the medical record number or other non-anonymous identifier. The assigning authority for an anonymous identifier would be the state/local health department.
ANC Account number Creditor
Class: Financial
A more precise definition of an account number: sometimes two distinct account numbers must be transmitted in the same message, one as the creditor and the other as the debtor.
AND Account number debitor
Class: Financial
A more precise definition of an account number: sometimes two distinct account numbers must be transmitted in the same message, one as the creditor and the other as the debtor.
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Value Description Comment
ANT Temporary Account Number Class: Financial
Temporary version of an Account Number.
Use Case: An ancillary system that does not normally assign account numbers is the first time to register a patient. This ancillary system will generate a temporary account number that will only be used until an official account number is assigned.
APRN Advanced Practice Registered Nurse number
An identifier that is unique to an advanced practice registered nurse within the jurisdiction of a certifying board
BA Bank Account Number Class: Financial
BC Bank Card Number Class: Financial
An identifier that is unique to a person’s bank card. Replaces AM, DI, DS, MS, and VS beginning in v 2.5.
BR Birth registry number
CC Cost Center number Class: Financial
Use Case: needed especially for transmitting information about invoices.
CY County number
DDS Dentist license number An identifier that is unique to a dentist within the jurisdiction of the licensing board
DEA Drug Enforcement Administration registration number
An identifier for an individual or organization relative to controlled substance regulation and transactions.
Use case: This is a registration number that identifies an individual or organization relative to controlled substance regulation and transactions.
A DEA number has a very precise and widely accepted meaning within the United States. Surprisingly, the US Drug Enforcement Administration does not solely assign DEA numbers in the United States. Hospitals have the authority to issue DEA numbers to their medical residents. These DEA numbers are based upon the hospital’s DEA number, but the authority rests with the hospital on the assignment to the residents. Thus, DEA as an Identifier Type is necessary in addition to DEA as an Assigning Authority.
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Value Description Comment
DFN Drug Furnishing or prescriptive authority Number
An identifier issued to a health care provider authorizing the person to write drug orders
Use Case: A nurse practitioner has authorization to furnish or prescribe pharmaceutical substances; this identifier is in component 1.
DL Driver’s license number
DN Doctor number
DPM Podiatrist license number An identifier that is unique to a podiatrist within the jurisdiction of the licensing board.
DO Osteopathic License number An identifier that is unique to an osteopath within the jurisdiction of a licensing board.
DR Donor Registration Number
EI Employee number A number that uniquely identifies an employee to an employer.
EN Employer number
FI Facility ID
GI Guarantor internal identifier Class: Financial
GL General ledger number Class: Financial
GN Guarantor external identifier Class: Financial
HC Health Card Number
JHN Jurisdictional health number (Canada)
Class: Insurance
2 uses: a) UK jurisdictional CHI number; b) Canadian provincial health card number:
IND Indigenous/Aboriginal A number assigned to a member of an indigenous or aboriginal group outside of Canada.
LI Labor and industries number
LN License number
LR Local Registry ID
MA Patient Medicaid number Class: Insurance
MB Member Number An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.
Use Case: Person is covered by an insurance policy. This person may or may not be the subscriber of the policy.
MC Patient’s Medicare number Class: Insurance
MCD Practitioner Medicaid number Class: Insurance
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Value Description Comment
MCN Microchip Number
MCR Practitioner Medicare number Class: Insurance
MD Medical License number An identifier that is unique to a medical doctor within the jurisdiction of a licensing board.
Use Case: These license numbers are sometimes used as identifiers. In some states, the same authority issues all three identifiers, e.g., medical, osteopathic, and physician assistant licenses all issued by one state medical board. For this case, the CX data type requires distinct identifier types to accurately interpret component 1. Additionally, the distinction among these license types is critical in most health care settings (this is not to convey full licensing information, which requires a segment to support all related attributes).
MI Military ID number A number assigned to an individual who has had military duty, but is not currently on active duty. The number is assigned by the DOD or Veterans’ Affairs (VA).
MR Medical record number An identifier that is unique to a patient within a set of medical records, not necessarily unique within an application.
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Value Description Comment
MRT Temporary Medical Record Number
Temporary version of a Medical Record Number
Use Case: An ancillary system that does not normally assign medical record numbers is the first time to register a patient. This ancillary system will generate a temporary medical record number that will only be used until an official medical record number is assigned.
NE National employer identifier In the US, the Assigning Authority for this value is typically CMS, but it may be used by all providers and insurance companies in HIPAA related transactions.
NH National Health Plan Identifier Class: Insurance
Used for the UK NHS national identifier.
In the US, the Assigning Authority for this value is typically CMS, but it may be used by all providers and insurance companies in HIPAA related transactions.
NI National unique individual identifier
Class: Insurance
In the US, the Assigning Authority for this value is typically CMS, but it may be used by all providers and insurance companies in HIPAA related transactions.
NII National Insurance Organization Identifier
Class: Insurance
In Germany a national identifier for an insurance company. It is printed on the insurance card (health card). It is not to be confused with the health card number itself.
NIIP National Insurance Payor Identifier (Payor)
Class: Insurance
Use case: a subdivision issues the card with their identifier, but the main division is going to pay the invoices.
NNxxx National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code
NP Nurse practitioner number An identifier that is unique to a nurse practitioner within the jurisdiction of a certifying board.
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Value Description Comment
NPI National provider identifier Class: Insurance
In the US, the Assigning Authority for this value is typically CMS, but it may be used by all providers and insurance companies in HIPAA related transactions.
OD Optometrist license number A number that is unique to an individual optometrist within the jurisdiction of the licensing board.
PA Physician Assistant number An identifier that is unique to a physician assistant within the jurisdiction of a licensing board
PCN Penitentiary/correctional institution Number
A number assigned to individual who is incarcerated.
PE Living Subject Enterprise Number An identifier that is unique to a living subject within an enterprise (as identified by the Assigning Authority).
PEN Pension Number
PI Patient internal identifier A number that is unique to a patient within an Assigning Authority.
PN Person number A number that is unique to a living subject within an Assigning Authority.
PNT Temporary Living Subject Number Temporary version of a Lining Subject Number.
PPN Passport number A unique number assigned to the document affirming that a person is a citizen of the country. In the US this number is issued only by the State Department.
PRC Permanent Resident Card Number
PRN Provider number A number that is unique to an individual provider, a provider group or an organization within an Assigning Authority.
Use case: This allows PRN to represent either an individual (a nurse) or a group/organization (orthopedic surgery team).
PT Patient external identifier
QA QA number
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Value Description Comment
RI Resource identifier A generalized resource identifier.
Use Case: An identifier type is needed to accommodate what are commonly known as resources. The resources can include human (e.g. a respiratory therapist), non-human (e.g., a companion animal), inanimate object (e.g., an exam room), organization (e.g., diabetic education class) or any other physical or logical entity.
RPH Pharmacist license number An identifier that is unique to a pharmacist within the jurisdiction of the licensing board.
RN Registered Nurse Number An identifier that is unique to a registered nurse within the jurisdiction of the licensing board.
RR Railroad Retirement number
RRI Regional registry ID
SL State license
SN Subscriber Number Class: Insurance
An identifier for a subscriber of an insurance policy which is unique for, and usually assigned by, the insurance carrier.
Use Case: A person is the subscriber of an insurance policy. The person’s family may be plan members, but are not the subscriber.
SR State registry ID
SS Social Security number
TAX Tax ID number
U Unspecified identifier
UPIN Medicare/CMS (formerly HCFA)’s Universal Physician Identification numbers
Class: Insurance
VN Visit number
WC WIC identifier
WCN Workers’ Comp Number
XX Organization identifier
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User-defined Table 0204 - Organizational name type
Values suggested by HL7 Use in all XON data types
Value Description
L Legal name
D Display name
HL7-defined Table 0207 - Processing mode
Use in MSH-11
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
User-defined Table 0208 - Query response status
Values suggested by HL7. Use in QAK-2)
Value Description
OK Data found, no errors (this is the default)
NF No data found, no errors
AE Application error
AR Application reject
TM Too many candidates found
HL7-defined Table 0211 - Alternate character sets
Use in MSH-18
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
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User-defined Table 0215 - Publicity code
Values suggested by CDC. (Use in PD1-11)
User-defined Table 0220 - Living arrangement
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0227 - Manufacturers of vaccines (code = MVX)
(Use in RXA-17) The table below represents the February 2010 version of the MVX code set. The CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) maintains the HL7 external code set MVX.
http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=mvx
NOTE: The MVX table reflects name changes and changes in corporate status. Where there have been company mergers/acquisitions, the affected old codes have been labeled “inactive. The inactive manufacturer codes are retained to allow manufacturer to be identified for historic immunization records. They should not be used for current immunizations. Inactive codes should not be cross-walked to the code for the current manufacturer.
Value
Description
01 No reminder/recall
02 Reminder/recall - any method
03 Reminder/recall - no calls
04 Reminder only - any method
05 Reminder only - no calls
06 Recall only - any method
07 Recall only - no calls
08 Reminder/recall - to provider
09 Reminder to provider
10 Only reminder to provider, no recall
11 Recall to provider
12 Only recall to provider, no reminder
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Alphabetized by manufacturer name
MVX CODE Manufacturer Name Notes Status
AB Abbott Laboratories includes Ross Products Division, Solvay Active
ACA Acambis, Inc. acquired by Sanofi in sept 2008 Inactive
AD Adams Laboratories, Inc. Active
ALP Alpha Therapeutic Corporation
Active
AR Armour part of CSL Inactive
AVB Aventis Behring L.L.C. part of CSL Inactive
AVI Aviron acquired by Medimmune Inactive
BA Baxter Healthcare Corporation-inactive
Inactive
BAH Baxter Healthcare Corporation
includes Hyland Immuno, Immuno International AG, and North American Vaccine, Inc./acquired some assets from alpha therapeutics
Active
BAY Bayer Corporation Bayer Biologicals now owned by Talecris Inactive
BP Berna Products Inactive
BPC Berna Products Corporation
includes Swiss Serum and Vaccine Institute Berne
Active
BTP Biotest Pharmaceuticals Corporation
New owner of NABI HB as of December 2007, Does NOT replace NABI Biopharmaceuticals in this code list.
Active
MIP Emergent Biodefense Operations Lansing
Bioport renamed. Formerly Michigan Biologic Products Institute
Active
CSL CSL Behring, Inc. CSL Biotherapies renamed to CSL Behring Active
CNJ Cangene Corporation Active
CMP Celltech Medeva Pharmaceuticals
Part of Novartis Inactive
CEN Centeon L.L.C. Inactive
CHI Chiron Corporation Part of Novartis Inactive
CON Connaught acquired by Merieux Inactive
DVC DynPort Vaccine Company, LLC
Active
EVN Evans Medical Limited Part of Novartis Inactive
GEO GeoVax Labs, Inc. Active
SKB GlaxoSmithKline includes SmithKline Beecham and Glaxo Wellcome
Active
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GRE Greer Laboratories, Inc. Active
IAG Immuno International AG Part of Baxter Inactive
IUS Immuno-U.S., Inc. Active
INT Intercell Biomedical Active
KGC Korea Green Cross Corporation
Active
LED Lederle became a part of WAL, now owned by Pfizer Inactive
MBL Massachusetts Biologic Laboratories
formerly Massachusetts Public Health Biologic Laboratories
Active
MA Massachusetts Public Health Biologic Laboratories
Inactive
MED MedImmune, Inc.
Acquired U.S. Bioscience in 1999 and Aviron in 2002, integrated with Cambridge Antibody Technology strategic alignment with new parent company, AstraZeneca, in 2007.
Active
MSD Merck & Co., Inc. Active
IM Merieux Part of Sanofi Inactive
MIL Miles Inactive
NAB NABI formerly North American Biologicals, Inc. Active
NYB New York Blood Center Active
NAV North American Vaccine, Inc.
part of Baxter Inactive
NOV Novartis Pharmaceutical Corporation
includes Chiron, PowderJect Pharmaceuticals, Celltech Medeva Vaccines and Evans Limited, Ciba-Geigy Limited and Sandoz Limited
Active
NVX Novavax, Inc. Active
OTC Organon Teknika Corporation
Active
ORT Ortho-clinical Diagnostics a J & J company (formerly Ortho Diagnostic Systems, Inc.)
Active
PD Parkedale Pharmaceuticals no website and no news articles (formerly Parke-Davis)
Inactive
PWJ PowderJect Pharmaceuticals
See Novartis Inactive
PRX Praxis Biologics became a part of WAL, now owned by Pfizer Inactive
JPN The Research Foundation for Microbial Diseases of Osaka University (BIKEN)
Active
PMC Sanofi Pasteur Formerly Aventis Pasteur, Pasteur Merieux Connaught; includes Connaught Laboratories and Pasteur Merieux. Acquired ACAMBIS.
Active
99
SCL Sclavo, Inc. Active
SOL Solvay Pharmaceuticals Part of Abbott Inactive
SI Swiss Serum and Vaccine Inst.
Part of Berna Inactive
TAL Talecris Biotherapeutics includes Bayer Biologicals Active
USA United States Army Medical Research and Material Command
Active
VXG VaxGen acquired by Emergent Biodefense Operations Lansing, Inc.
Inactive
WA Wyeth-Ayerst became WAL, now owned by Pfizer Inactive
WAL Wyeth acquired by Pfizer 10/15/2009 Active
ZLB ZLB Behring acquired by CSL Inactive
OTH Other manufacturer Active
UNK Unknown manufacturer Active
AKR Akorn, Inc. Active
PFR Pfizer, Inc. includes Wyeth-Lederle Vaccines and Pediatrics, Wyeth Laboratories, Lederle Laboratories, and Praxis Biologics,
Active
BRR Barr Laboratories Subsidiary of Teva Pharmaceuticals Active
User-defined Table 0288 - Census tract
Use in all XAD; including PID-11 Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
User-defined Table 0289 - County/parish
Use in all XAD; including PID-11
A complete list of FIPS 6-4 county codes is available at http://www.itl.nist.gov/fipspubs/co-codes/states.htm
According to the FIPS guidance, the 2-letter state code (available at <http://www.itl.nist.gov/div897/pubs/fip5-2.htm>) plus the numeric county code should be used (e.g., AZ001 represents Apache County, Arizona and AL001 represents Autauga County, Alabama).
100
HL7-defined Table 0292 - Codes for Vaccines administered (code=CVX)
Use in RXA-5
The table below represents the September 2013 version of the CVX code set. New codes are added as needed; therefore, see the most current version of this code set at the website Web site: http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx
The CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) maintains the HL7 external code set CVX.
CVX – Vaccines Administered
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
99 RESERVED - do not use
RESERVED - do not use
Code 99 will not be used in this table to avoid confusion with code 999.
Inactive
998 no vaccine administered
no vaccine administered
Code 998 was added for use in VXU HL7 messages where the OBX segment is nested with the RXA segment, but the message does not contain information about a vaccine administration. An example of this use is to report the vaccines due next for a patient when no vaccine administration is being reported.
Inactive
999 unknown unknown vaccine or immune globulin
This CVX code has little utility and should rarely be used.
Inactive
143 Adenovirus types 4 and 7
Adenovirus, type 4 and type 7, live, oral
This vaccine is administered as 2 tablets.
Active
54 adenovirus, type 4
adenovirus vaccine, type 4, live, oral
Inactive
55 adenovirus, type 7
adenovirus vaccine, type 7, live, oral
Inactive
101
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
82 adenovirus, unspecified formulation
adenovirus vaccine, unspecified formulation
This CVX code is intended to allow reporting of adenovirus vaccinations where the formulation is not known. For example, this may occur if a historic record of an adenovirus vaccination is recorded from a vaccination card.
Inactive
24 anthrax anthrax vaccine Active
19 BCG Bacillus Calmette-Guerin vaccine
Active
27 botulinum antitoxin
botulinum antitoxin Active
26 cholera cholera vaccine Inactive
29 CMVIG cytomegalovirus immune globulin, intravenous
Active
56 dengue fever dengue fever vaccine Never Active
12 diphtheria antitoxin
diphtheria antitoxin Active
28 DT (pediatric)
diphtheria and tetanus toxoids, adsorbed for pediatric use
Active
20 DTaP diphtheria, tetanus toxoids and acellular pertussis vaccine
Active
106 DTaP, 5 pertussis antigens
diphtheria, tetanus toxoids and acellular pertussis vaccine, 5 pertussis antigens
Active
102
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
107 DTaP, unspecified formulation
diphtheria, tetanus toxoids and acellular pertussis vaccine, unspecified formulation
This CVX code is intended to allow reporting of DTAP vaccinations where the formulation is not known. For example, this may occur if a historic record of an DTAP vaccination is recorded from a vaccination card.
Inactive
146 DTap, IPV, Hib, HepB
Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus, Haemophilus b Conjugate (Meningococcal Outer Membrane Protein Complex), and Hepatitis B (Recombinant) Vaccine.
Pending Last update from CDC 8/31/2011
110 DTaP-Hep B-IPV DTaP-hepatitis B and poliovirus vaccine
Active
50 DTaP-Hib DTaP-Haemophilus Influenzae type b conjugate vaccine
Active
103
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
120 DTaP-Hib-IPV
diphtheria, tetanus toxoids and acellular pertussis vaccine, Haemophilus influenzae type b conjugate, and poliovirus vaccine, inactivated (DTaP-Hib-IPV)
Active
130 DTaP-IPV
Diphtheria, tetanus toxoids and acellular pertussis vaccine, and poliovirus vaccine, inactivated
Active
132 DTaP-IPV-HIB-HEP B, historical
Historical record of vaccine containing * diphtheria, tetanus toxoids and acellular pertussis, * poliovirus, inactivated, * Haemophilus influenzae type b conjugate, * Hepatitis B (DTaP-Hib-IPV)
Inactive
01 DTP diphtheria, tetanus toxoids and pertussis vaccine
Inactive
22 DTP-Hib DTP-Haemophilus influenzae type b conjugate vaccine
Inactive
102 DTP-Hib-Hep B
DTP- Haemophilus influenzae type b conjugate and hepatitis b vaccine
Inactive
57 hantavirus hantavirus vaccine Never Active
30 HBIG hepatitis B immune globulin
Active
52 Hep A, adult hepatitis A vaccine, adult dosage
Active
104
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
154 Hep A IG Hepatitis A immune globlin
Never active
Don’t use this code. The correct vaccine code is 86 (IG)
83 Hep A, ped/adol, 2 dose
hepatitis A vaccine, pediatric/adolescent dosage, 2 dose schedule
Active
84 Hep A, ped/adol, 3 dose
hepatitis A vaccine, pediatric/adolescent dosage, 3 dose schedule
This vaccine formulation is inactive and should not be used, except to record historic vaccinations with this formulation.
Inactive
31 Hep A, pediatric, unspecified formulation
hepatitis A vaccine, pediatric dosage, unspecified formulation
Do NOT use this code. If formulation is unknown, use CVX 85. There is only one formulation of Hep A, peds.
Inactive
85 Hep A, unspecified formulation
hepatitis A vaccine, unspecified formulation
This CVX code is intended to allow reporting of Hep A vaccinations where the formulation is not known. For example, this may occur if a historic record of an Hep A vaccination is recorded from a vaccination card.
Inactive
104 Hep A-Hep B hepatitis A and hepatitis B vaccine
Active
105
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
08 Hep B, adolescent or pediatric
hepatitis B vaccine, pediatric or pediatric/adolescent dosage
This code applies to any standard pediatric formulation of Hepatitis B vaccine. It should not be used for the 2-dose hepatitis B schedule for adolescents (11-15 year olds). It requires Merck’s Recombivax HB® adult formulation. Use code 43 for that vaccine.
Active
42 Hep B, adolescent/high risk infant
hepatitis B vaccine, adolescent/high risk infant dosage
As of August 27, 1998, Merck ceased distribution of their adolescent/high risk infant hepatitis B vaccine dosage. Code 42 should only be used to record historical records. For current administration of hepatitis B vaccine, pediatric/adolescent dosage, use code 08.
Inactive
43 Hep B, adult hepatitis B vaccine, adult dosage
As of September 1999, a 2-dose hepatitis B schedule for adolescents (11-15 year olds) was FDA approved for Merck’s Recombivax HB® adult formulation. Use code 43 for the 2-dose. This code should be used for any use of standard adult formulation of hepatitis B vaccine.
Active
106
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
44 Hep B, dialysis hepatitis B vaccine, dialysis patient dosage
Active
45 Hep B, unspecified formulation
hepatitis B vaccine, unspecified formulation
This CVX code is intended to allow reporting of hepatitis B vaccinations where the formulation is not known. For example, this may occur if a historic record of a Hep B vaccination is recorded from a vaccination card.
Inactive
58 Hep C hepatitis C vaccine Never Active
59 Hep E hepatitis E vaccine Never Active
60 herpes simplex 2 herpes simplex virus, type 2 vaccine
Never Active
47 Hib (HbOC)
Haemophilus influenzae type b vaccine, HbOC conjugate
Inactive
46 Hib (PRP-D)
Haemophilus influenzae type b vaccine, PRP-D conjugate
Inactive
49 Hib (PRP-OMP)
Haemophilus influenzae type b vaccine, PRP-OMP conjugate
Active
48 Hib (PRP-T)
Haemophilus influenzae type b vaccine, PRP-T conjugate
Active
17 Hib, unspecified formulation
Haemophilus influenzae type b vaccine, conjugate unspecified formulation
Inactive
51 Hib-Hep B
Haemophilus influenzae type b conjugate and Hepatitis B vaccine
Active
107
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
61 HIV human immunodeficiency virus vaccine
Never Active
118 HPV, bivalent human papilloma virus vaccine, bivalent
Active
62 HPV, quadrivalent
human papilloma virus vaccine, quadrivalent
Active
137 HPV, unspecified formulation
HPV, unspecified formulation
This CVX code is intended to allow reporting of HPV vaccinations where the formulation is not known. For example, this may occur if a historic record of an HPV vaccination is recorded from a vaccination card.
Inactive
86 IG immune globulin, intramuscular
Active
14 IG, unspecified formulation
immune globulin, unspecified formulation
Inactive
87 IGIV immune globulin, intravenous
Active
151 Influenza nasal unspecified formulation
151 Inactive 1/28/2013
123 influenza, H5N1-1203
influenza virus vaccine, H5N1, A/Vietnam/1203/2004 (national stockpile)
Inactive
108
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
135 Influenza, high dose seasonal
influenza, high dose seasonal, preservative-free
Active
153
Influenza, injectable MDCH, preservative free
Influenza, injectable, Madin Darby Canine Kidney, preservative free
Active 7/17/13
158 Influenza, injectable quadrivalent
Influenza, injectable quadrivalent, contains preservative
Active 8/20/2013
150
Influenza, injectable quadrivalent preservative free
Influenza, injectable quadrivalent preservative free
7/17/2013
111 influenza, live, intranasal
influenza virus vaccine, live, attenuated, for intranasal use
Seasonal Influenza Active
141 Influenza, seasonal, injectable
Influenza, seasonal, injectable
This is one of two codes replacing CVX 15, which is being retired.
Active
140
Influenza, seasonal, injectable, preservative free
Influenza, seasonal, injectable, preservative free
This vaccine code is one of two which replace CVX 15, influenza, split virus.
Active
144
influenza, seasonal, intradermal, preservative free
seasonal influenza, intradermal, preservative free
Active
15 influenza, split (incl. purified surface antigen)
influenza virus vaccine, split virus (incl. purified surface antigen)-retired CODE
This code is being retired. It will still be found in older immunization records. It included both preservative free and non-preservative free.
Inactive
109
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
88 influenza, unspecified formulation
influenza virus vaccine, unspecified formulation
This CVX code is intended to allow reporting of seasonal flu vaccinations where the formulation is not known. For example, this may occur if a historic record of an seasonal flu vaccination is recorded from a vaccination card.
Inactive
16 influenza, whole influenza virus vaccine, whole virus
Inactive
10 IPV poliovirus vaccine, inactivated
Active
134 Japanese Encephalitis IM
Japanese Encephalitis vaccine for intramuscular administration
Active
39 Japanese encephalitis SC
Japanese Encephalitis Vaccine SC
Active
129
Japanese Encephalitis, unspecified formulation
Japanese Encephalitis vaccine, unspecified formulation
This CVX code is intended to allow reporting of JE vaccinations where the formulation is not known. For example, this may occur if a historic record of an JE vaccination is recorded from a vaccination card.
Inactive
63 Junin virus Junin virus vaccine Never Active
64 leishmaniasis leishmaniasis vaccine Never Active
65 leprosy leprosy vaccine Never Active
66 Lyme disease Lyme disease vaccine Inactive
04 M/R measles and rubella virus vaccine
Inactive
67 malaria malaria vaccine Never Active
05 measles measles virus vaccine Inactive
110
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
68 melanoma melanoma vaccine Never Active
103 meningococcal C conjugate
meningococcal C conjugate vaccine
Inactive
148 Meningococcal, C/Y HIB PRP
Meningococcal Groups C and Y and Haemophilus b Tetanus Toxoid Conjugate Vaccine
Active 7/11/2012
147
meningococcal MCV4, unspecified formulation
Meningococcal, MCV4, unspecified formulation(groups A, C, Y and W-135)
Inactive 2/8/2012
136 Meningococcal MCV4O
meningococcal oligosaccharide (groups A, C, Y and W-135) diphtheria toxoid conjugate vaccine (MCV4O)
Active
114 meningococcal MCV4P
meningococcal polysaccharide (groups A, C, Y and W-135) diphtheria toxoid conjugate vaccine (MCV4P)
Active
32 meningococcal MPSV4
meningococcal polysaccharide vaccine (MPSV4)
Active
108 meningococcal, unspecified formulation
meningococcal vaccine, unspecified formulation
This CVX code is intended to allow reporting of meningococcal vaccinations where the formulation is not known. For example, this may occur if a historic record of meningococcal vaccination is recorded from a vaccination card.
Inactive
03 MMR measles, mumps and rubella virus vaccine
Active
111
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
94 MMRV measles, mumps, rubella, and varicella virus vaccine
Active
07 mumps mumps virus vaccine Active
127 Novel influenza-H1N1-09
Novel influenza-H1N1-09, injectable
Inactive
128 Novel Influenza-H1N1-09, all formulations
Novel influenza-H1N1-09, all formulations
This code is used whenever the actual formulation is not determined or when aggregating all Novel H1N1 Influenza-09 immunizations for reporting to CRA. It should not be used for seasonal influenza vaccine that is not otherwise specified. (NOS)
Inactive
125 Novel Influenza-H1N1-09, nasal
Novel Influenza-H1N1-09, live virus for nasal administration
Inactive
126 Novel influenza-H1N1-09, preservative-free
Novel influenza-H1N1-09, preservative-free, injectable
Inactive
02 OPV poliovirus vaccine, live, oral
Inactive
69 parainfluenza-3 parainfluenza-3 virus vaccine
Inactive
11 pertussis pertussis vaccine Inactive
23 plague plague vaccine Active
133 Pneumococcal conjugate PCV 13
pneumococcal conjugate vaccine, 13 valent
Active
100 pneumococcal conjugate PCV 7
pneumococcal conjugate vaccine, 7 valent
Active
112
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
152
Pneumococcal Conjugate, unspecified formulation
Pneumococcal Conjugate, unspecified formulation
Inactive 1/28/2013
33 pneumococcal polysaccharide PPV23
pneumococcal polysaccharide vaccine, 23 valent
Active
109 pneumococcal, unspecified formulation
pneumococcal vaccine, unspecified formulation
This CVX code is intended to allow reporting of pneumococcal vaccinations where the formulation is not known. For example, this may occur if a historic record of a pneumococcal vaccination is recorded from a vaccination card.
Inactive
89 polio, unspecified formulation
poliovirus vaccine, unspecified formulation
Inactive
70 Q fever Q fever vaccine Never Active
40 rabies, intradermal injection
rabies vaccine, for intradermal injection
Active
18 rabies, intramuscular injection
rabies vaccine, for intramuscular injection
Active
90 rabies, unspecified formulation
rabies vaccine, unspecified formulation
Inactive
72 rheumatic fever rheumatic fever vaccine
Never Active
113
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
157 Rho(D) -IG IM
Rho(D) Immune globulin - IM
This immune globulin may be administered IM only.
Active 8/13/2013
156 Rho(D)-IG
Rho(D) Immune globulin- IV or IM
This immune globulin may be administered either IM or IV.
Active 7/26/2013
73 Rift Valley fever Rift Valley fever vaccine
Never Active
34 RIG rabies immune globulin
Active
119 rotavirus, monovalent
rotavirus, live, monovalent vaccine
Active
116 rotavirus, pentavalent
rotavirus, live, pentavalent vaccine
Active
74 rotavirus, tetravalent
rotavirus, live, tetravalent vaccine
Inactive
122 rotavirus, unspecified formulation
rotavirus vaccine, unspecified formulation
Inactive
71 RSV-IGIV respiratory syncytial virus immune globulin, intravenous
Active
93 RSV-MAb
respiratory syncytial virus monoclonal antibody (palivizumab), intramuscular
Active
145 RSV-MAb (new)
respiratory syncytial virus monoclonal antibody (motavizumab), intramuscular
Pending
06 rubella rubella virus vaccine Active
38 rubella/mumps rubella and mumps virus vaccine
Inactive
76 Staphylococcus bacterio lysate
Staphylococcus bacteriophage lysate
Inactive
114
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
138 Td (adult)
tetanus and diphtheria toxoids, not adsorbed, for adult use
Note that this Td is not adsorbed.
Active
113 Td (adult) preservative free
tetanus and diphtheria toxoids, adsorbed, preservative free, for adult use
Active
09 Td (adult), adsorbed
tetanus and diphtheria toxoids, adsorbed, for adult use
Note that this vaccine name has changed. See also Td (adult). It is not adsorbed.
Active
139 Td(adult) unspecified formulation
Td(adult) unspecified formulation
This CVX code is intended to allow reporting of Td vaccinations where the formulation is not known. For example, this may occur if a historic record of an Td vaccination is recorded from a vaccination card.
Inactive
115 Tdap
tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine, adsorbed
Active
35 tetanus toxoid, adsorbed
tetanus toxoid, adsorbed
Active
142 tetanus toxoid, not adsorbed
tetanus toxoid, not adsorbed
Active
112 tetanus toxoid, unspecified formulation
tetanus toxoid, unspecified formulation
Inactive
77 tick-borne encephalitis
tick-borne encephalitis vaccine
Inactive
13 TIG tetanus immune globulin
Active
98 TST, unspecified formulation
tuberculin skin test; unspecified formulation
TB Skin test is not vaccine.
Inactive
115
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
95 TST-OT tine test tuberculin skin test; old tuberculin, multipuncture device
TB Skin test is not vaccine.
Inactive
96 TST-PPD intradermal
tuberculin skin test; purified protein derivative solution, intradermal
TB Skin test is not vaccine.
Inactive
97 TST-PPD tine test
tuberculin skin test; purified protein derivative, multipuncture device
TB Skin test is not vaccine.
Inactive
78 tularemia vaccine
tularemia vaccine Inactive
25 typhoid, oral typhoid vaccine, live, oral
Active
41 typhoid, parenteral
typhoid vaccine, parenteral, other than acetone-killed, dried
Active
53 typhoid, parenteral, AKD (U.S. military)
typhoid vaccine, parenteral, acetone-killed, dried (U.S. military)
Active
91 typhoid, unspecified formulation
typhoid vaccine, unspecified formulation
Inactive
101 typhoid, ViCPs typhoid Vi capsular polysaccharide vaccine
Active
131 typhus, historical Historical record of a typhus vaccination
Inactive
75 vaccinia (smallpox)
vaccinia (smallpox) vaccine
Active
105 vaccinia (smallpox) diluted
vaccinia (smallpox) vaccine, diluted
Inactive
79 vaccinia immune globulin
vaccinia immune globulin
Active
21 varicella varicella virus vaccine Active
81 VEE, inactivated Venezuelan equine encephalitis, inactivated
Inactive
80 VEE, live Venezuelan equine encephalitis, live, attenuated
Inactive
116
CVX Code
Short Description
Full Vaccine Name Note Vaccine Status
92 VEE, unspecified formulation
Venezuelan equine encephalitis vaccine, unspecified formulation
Inactive
36 VZIG varicella zoster immune globulin
Active
117 VZIG (IND)
varicella zoster immune globulin (Investigational New Drug)
Inactive
37 yellow fever yellow fever vaccine Active
121 zoster zoster vaccine, live Active
User-defined Table 0296 - Language
ISO 639 shall be used for Language. It is available from PHIN-VADS at:
http://phinvads.cdc.gov/vads/ViewValueSet.action?id=43D34BBC-617F-DD11-B38D-00188B398520#
The code used from HL70396 table is ISO6392.
Example codes are found in the table below.
Value Description
ara Arabic
arm Armenian
cat Catalan; Valencian
chi Chinese
dan Danish
eng English
fre French
ger German
hat Haitian; Haitian Creole
heb Hebrew
hin Hindi
hmn Hmong
jpn Japanese
kor Korean
rus Russian
som Somali
spa Spanish; Castilian
vie Vietnamese
117
User-defined Table 0297 - CN ID source
Use in all XCN data types. [locally-defined]
User-defined Table 0300 - Namespace ID
Use in all EI, HD data types
[locally-defined]
See tables 0361-0363 for Application Identifier, Facility Identifier, and Assigning Authority. These tables are more specific than 0300 and are preferred.
HL7-defined Table 0301 - Universal ID type
Use in all HD data types
Value Description
DNS An Internet dotted name—either in ASCII or as integers.
GUID Same as UUID.
HCD The CEN Healthcare Coding Scheme Designator. (Identifiers used in DICOM follow this assignment scheme.)
HL7 Reserved for future HL7 registration schemes.
ISO An International Standards Organization Object Identifier.
L,M,N These are reserved for locally defined coding schemes.
Random Usually a base64 encoded string of random bits. The uniqueness depends on the length of the bits. Mail systems often generate ASCII string “unique names,” from a combination of random bits and system names. Obviously, such identifiers will not be constrained to the base64 character set.
UUID The DCE Universal Unique Identifier.
x400 An X.400 MHS format identifier.
x500 An X.500 directory name.
HL7-defined Table 0322 - Completion status
Use in RXA-20
Value Description
CP Complete
RE Refused
NA Not Administered
PA Partially Administered
118
HL7-defined Table 0323 - Action code
Use in RXA-21
Value Description
A Add
D Delete
U Update
HL7-defined Table 0354 - Message structure Use in MSH-9, third component. [Only selected values listed]
Value
Events
ACK ACK
QBP_Q11 QBP
RSP_K11 RSP
VXU_V04 VXU
HL7-defined Table 0356 - Alternate character set handling scheme
Use in MSH-20
Fields using this code set are expected to be empty. For a current list of HL7 values please reference the HL7 version 2.5.1 documents.
HL7-defined Table 0357 - Message error status codes
(Use in ERR-3)
Status code
Status text
Description/Comment
Success
0 Message accepted Success. Optional, as the AA conveys this. Used for systems that must always return a status code.
Error status codes
100 Segment sequence error The message segments were not in the proper order or required segments are missing.
101 Required field missing A required field is missing from the segment.
102 Data type error The field contained data of the wrong data type, e.g., an NM field contained letters of the alphabet.
103 Table value not found A field of data type ID or IS was compared against the corresponding table, and no match was found.
Rejection status codes
200 Unsupported message type The Message type is not supported.
201 Unsupported event code The Event Code is not supported.
202 Unsupported processing ID The Processing ID is not supported.
203 Unsupported version ID The Version ID is not supported.
119
Status code
Status text
Description/Comment
204 Unknown key identifier The ID of the patient, order, etc. was not found. Used for transactions other than additions, e.g., transfer of a non-existent patient.
205 Duplicate key identifier The ID of the patient, order, etc. already exists. Used in response to addition transactions (Admit, New Order, etc.).
206 Application record locked The transaction could not be performed at the application storage level, e.g., database locked.
207 Application internal error A catchall for internal errors not explicitly covered by other codes.
User-defined Table 0360 – Degree
Selected values suggested by HL7. ; (use in all XPN data types, including PID-5, 6, 9)
Value Description
PN Advanced Practice Nurse
AA Associate of Arts
AS Associate of Science
BA Bachelor of Arts
BN Bachelor of Nursing
BS Bachelor of Science
BSN Bachelor of Science in Nursing
CER Certificate
CANP Certified Adult Nurse Practitioner
CMA Certified Medical Assistant
CNP Certified Nurse Practitioner
CNM Certified Nurse Midwife
CNA Certified Nurse’s Assistant
CRN Certified Registered Nurse
CNS Certified Nurse Specialist
CPNP Certified Pediatric Nurse Practitioner
DIP Diploma
PHD Doctor of Philosophy
MD Doctor of Medicine
DO Doctor of Osteopathy
EMT Emergency Medical Technician
EMT-P Emergency Medical Technician – Paramedic
FPNP Family Practice Nurse Practitioner
HS High School Graduate
JD Juris Doctor
LPN Licensed Practical Nurse
MA Master of Arts
120
Value
Description
MBA Master of Business Administration
MPH Master of Public Health
MS Master of Science
MSN Master of Science – Nursing
MDA Medical Assistant
MT Medical Technician
NG Non-Graduate
NP Nurse Practitioner
PharmD Doctor of Pharmacy
PA Physician Assistant
PHN Public Health Nurse
RMA Registered Medical Assistant
RN Registered Nurse
RPH Registered Pharmacist
SEC Secretarial Certificate
TS Trade School Graduate
User-defined Table 0361 – Application
No suggested values defined.
User-defined Table 0362 – Facility
No suggested values defined.
User-defined Table 0363 – Assigning Authority
Local implementations will need to add codes to this table to identify local assigning authorities. The values in this table are intended to be used by state and regional immunization programs.
Code Grantee
AKA ALASKA
ALA ALABAMA
ARA ARKANSAS
ASA AMERICAN SAMOA
AZA ARIZONA
BAA NEW YORK CITY
CAA CALIFORNIA
CHA CHICAGO
COA COLORADO
CTA CONNECTICUT
DCA DISTRICT OF COLUMBIA
DEA DELAWARE
FLA FLORIDA
121
FMA FED STATES MICRO
GAA GEORGIA
GUA GUAM
HIA HAWAII
IAA IOWA
IDA IDAHO
ILA ILLINOIS
INA INDIANA
KSA KANSAS
KYA KENTUCKY
LAA LOUISIANA
MAA MASSACHUSETTS
MDA MARYLAND
MEA MAINE
MHA REP MARS ISLANDS
MIA MICHIGAN
MNA MINNESOTA
MOA MISSOURI
MPA NO. MARIANA ISLAND
MSA MISSISSIPPI
MTA MONTANA
NCA NORTH CAROLINA
NDA NORTH DAKOTA
NEA NEBRASKA
NHA NEW HAMPSHIRE
NJA NEW JERSEY
NMA NEW MEXICO
NVA NEVADA
NYA NEW YORK STATE
OHA OHIO
OKA OKLAHOMA
ORA OREGON
PAA PENNSYLVANIA
PHA PHILADELPHIA
PRA PUERTO RICO
RIA RHODE ISLAND
RPA REPUBLIC PALAU
SCA SOUTH CAROLINA
SDA SOUTH DAKOTA
TBA SAN ANTONIO
THA HOUSTON
TNA TENNESSEE
TXA TEXAS
UTA UTAH
122
VAA VIRGINIA
VIA VIRGIN ISLANDS
VTA VERMONT
WAA WASHINGTON
WIA WISCONSIN
WVA WEST VIRGINIA
WYA WYOMING
User-defined Table 0396 – Coding system
[only selected values listed] See Version 2.5.1 Table 0396 for other values. Use in CE data types to denote the coding system used for coded values
Value Description
99zzz or L Local general code (where z is an alphanumeric character)
ART WHO Adverse Reaction Terms C4 CPT-4 C5 CPT-5 CDCA CDC Analyte Codes CDCM CDC Methods/Instruments Codes CDCPHINVS PHIN VS (CDC Local Coding System) CDS CDC Surveillance CPTM CPT Modifier Code CST COSTART CVX CDC Vaccine Codes E EUCLIDES E5 Euclides quantity codes E6 Euclides Lab method codes E7 Euclides Lab equipment codes ENZC Enzyme Codes HB HIBCC HCPCS HCFA Common Procedure Coding System HHC Home Health Care HL7nnnn HL7 Defined Codes where nnnn is the HL7 table number HPC HCFA Procedure Codes (HCPCS) I10 ICD-10 I10P ICD-10 Procedure Codes I9 ICD9 I9C ICD-9CM ISOnnnn ISO Defined Codes where nnnn is the ISO table number LB Local billing code LN Logical Observation Identifier Names and Codes (LOINC) MCD Medicaid MCR Medicare MEDR Medical Dictionary for Drug Regulatory Affairs (MEDDRA) MVX CDC Vaccine Manufacturer Codes NDC National drug codes NCIT NCI Thesaurus NPI National Provider Identifier SNM Systemized Nomenclature of Medicine (SNOMED)
123
Value Description
SCT SNOMED Clinical Terminology SCT2 SNOMED Clinical Terms alphanumeric codes SNM3 SNOMED International SNT SNOMED topology codes (anatomic sites) UML Unified Medical Language UPC Universal Product Code UPIN UPIN W1 WHO record # drug codes (6 digit) W2 WHO record # drug codes (8 digit) W4 WHO record # code with ASTM extension WC WHO ATC
User-defined Table 0441 - Immunization registry status
Use in PD1-16.
Value
Description
A Active
I Inactive—Unspecified
L Inactive-Lost to follow-up (cannot contact)
M Inactive-Moved or gone elsewhere (transferred)
P Inactive-Permanently inactive (do not re-activate or add new entries to this record)
U Unknown
The code O (Other) has been removed, do not use
User-defined Table 0471 – Query Name
Value Description
Z34 Request Immunization History
HL7 Table 0516 - Error Severity (use in ERR-4)
Value Description Comment
W Warning Transaction successful, but there may be issues. These may include non-fatal errors with potential for loss of data.
I Information Transaction successful, but includes returned information.
E Error Transaction was not successful.
124
User-defined Table 0533 – Application Error Code
There are no suggested values for this code. Local implementations need to create a table of local application error codes.
CDC-defined NIP001 - Immunization information source
Use in RXA-9
Value Description
00 New immunization record
01 Historical information - source unspecified
02 Historical information - from other provider
03 Historical information - from parent’s written record
04 Historical information - from parent’s recall
05 Historical information - from other registry
06 Historical information - from birth certificate
07 Historical information - from school record
08 Historical information - from public agency
CDC-defined NIP002 - Substance refusal reason
Use in RXA-18
Value Description
00 Parental decision
01 Religious exemption
02 Other (must add text component of the CE field with description)
03 Patient decision
125
CDC-defined NIP003 - Observation identifiers
Use in OBX-3)10
31044-1
Reaction (CE) Value Set OID - 2.16.840.1.114222.4.11.3289 Value Set Code:: PHVS_VaccinationReaction_IIS
LOINC
® Code11
Description
Corresponding data type (indicate in OBX-2)
Corresponding observation value EXAMPLE OR code table to use (value in OBX-5)
Vaccine Funding Program Eligibility Category—Use in OBX-3 to indicate that OBX-5 will contain the funding program eligibility category for a given immunization.
64994-7
Vaccine funding program eligibility category
(CE) HL70064
Vaccine Type Identifier
30956-7
Vaccine Type (Vaccine group or family)
(CE) HL70292
(CVX codes – use the codes described as “unspecified formulation” as needed.)
38890-0
Component Vaccine Type (CE) HL70292
(CVX codes – use the codes described as “unspecified formulation” as needed.)
Contraindications, Precautions, Indications and Immunities
30946-8
Vaccination contraindication/precaution effective date
(DT) 19970522
30944-3
Vaccination temporary contraindication/precaution expiration date
(DT) 19990523
30945-0
Vaccination contraindication/precaution
(CE) Value Set OID - 2.16.840.1.114222.4.11.3288 Value Set Code:: PHVS_VaccinationContraindication_IIS
126
59785-6 Indications to immunize
(CE) Value Set OID - 2.16.840.1.114222.4.11.3290 Value Set Code:: PHVS_VaccinationSpecialIndications_IIS
Vaccine Information Statement (VIS) Dates
29768-9 Date Vaccine Information Statement Published
(TS) 19900605
29769-7 Date Vaccine Information Statement Presented
(TS) 199307311615
Forecasting and Evaluating Immunizations
30973-2 30973-2 -- Dose number in series
(NM) 2
30979-9 Vaccines due next
(CE) HL70292 (CVX)
30980-7 30980-7 – Date vaccine due
(TS) 19980526
30981-5 30981-5 – Earliest date to give
(TS) 19980522
30982-3 30982-3 – Reason applied by forecast logic to project this vaccine
(CE) or (ST)
Codes for forecast logic reason locally defined.
59779-9 Immunization Schedule used
CE Value Set OID - 2.16.840.1.114222.4.11.3291 Value Set Code:: PHVS_ImmunizationScheduleIdentifier_IIS
59780-7 Immunization Series name
CE Locally Defined
59782-3 Number of doses in primary series
NM 2
59784-9
Disease with presumed immunity
(CE) Value Set OID - 2.16.840.1.114222.4.11.3293
Value Set Code:: PHVS_EvidenceOfImmunity_IIS
127
59781-5 Dose validity ID Y, N or empty
59783-1 Status in immunization series
CE Locally defined value set
Smallpox Take Read: These codes allow information about evaluation of a smallpox vaccination, called the take response.
46249-9 VACCINATION TAKE-RESPONSE TYPE
(ST) Major Take, Equivocal, Not Available
46250-7 VACCINATION TAKE-RESPONSE DATE
(TS) 20091221
LOINC® codes are copyright 1995-2009, Regenstrief Institute and the Logical Observation Identifier Names and Codes (LOINC®) Committee. All rights reserved.
The following CDC defined tables are not included in this Guide. They support VAERS reporting, which not within the scope of this Guide.
NIP 005 – Event Consequences
NIP 007 – Vaccinated at Location
NIP 008 – Vaccine purchased with Funds
NIP 009 – Adverse event previously reported
NIP 010 – Report type
The following value sets replace a number of CDC defined tables. These have been registered in the CDC local value set, CDCPHINVS. Where appropriate, existing codes are used. For example SNOMED codes are used for some contraindications. Local codes (VXCxx) will be replaced as new SNOMED codes are published.
CDC-defined NIP004 - Contraindications, Precautions, and Immunities
This table has been replaced by separate tables for contraindications, indications, reactions and immunities
128
Value Set Name – Vaccination Contraindications
Used in OBX- 5
Value Set OID - 2.16.840.1.114222.4.11.3288
Value Set Code:: PHVS_VaccinationContraindication_IIS
Value set definition: indicates a contraindication to vaccination.
Code Set OID:
SNOMED: 2.16.840.1.113883.6.96
CDCPHINVS: 2.16.840.1.114222.4.5.274
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
VXC30
allergy (anaphylactic) to proteins of rodent or neural origin
allergy (anaphylactic) to proteins of rodent or neural origin CDCPHINVS
VXC17
allergy (anaphylactic) to 2-phenoxyethanol
allergy (anaphylactic) to 2-phenoxyethanol CDCPHINVS
VXC18
allergy to baker’s yeast (anaphylactic)
allergy to baker’s yeast (anaphylactic) CDCPHINVS
03
91930004 Allergy to eggs (disorder)
allergy to egg ingestion (anaphylactic) SCT
04
294847001 Gelatin allergy (disorder) allergy to gelatin (anaphylactic) SCT
05
294468006 Neomycin allergy (disorder)
allergy to neomycin (anaphylactic) SCT
06
294466005 Streptomycin allergy (disorder)
allergy to streptomycin (anaphylactic) SCT
07
VXC19
allergy to thimerosal (anaphylactic)
allergy to thimerosal (anaphylactic) CDCPHINVS
08
129
Concept
Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
VXC20
allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic)
allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) CDCPHINVS
09
402306009 Allergy to aluminum (disorder)
allergy (anaphylactic) to alum SCT
300916003 Latex allergy (disorder)
allergy (anaphylactic) to latex SCT
294530006 Polymyxin B allergy (disorder)
allergy (anaphylactic) to polymycin B SCT
VXC21 Previous history of intussusception
Previous history of intussusception CDCPHINVS
VXC22
encephalopathy within 7 days of previous dose of DTP or DTaP
encephalopathy within 7 days of previous dose of DTP or DTaP CDCPHINVS
15
VXC23
current fever with moderate-to-severe illness
current fever with moderate-to-severe illness CDCPHINVS
16
VXC24
current acute illness, moderate to severe (with or without fever) (e.g., diarrhea, otitis media, vomiting)
current acute illness, moderate to severe (with or without fever) (e.g., diarrhea, otitis media, vomiting) CDCPHINVS
21
27624003 Chronic disease (disorder)
chronic illness (e.g., chronic gastrointestinal disease) SCT
22
VXC25
History of Arthus hypersensitivity reaction to a tetanus-containing vaccine administered < 10 years previously
History of Arthus hypersensitivity reaction to a tetanus-containing vaccine administered < 10 years previously CDCPHINVS
130
Concept
Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
VXC26
underlying unstable, evolving neurologic disorders, (including seizure disorders, cerebral palsy, and developmental delay)
underlying unstable, evolving neurologic disorders, (including seizure disorders, cerebral palsy, and developmental delay) CDCPHINVS
37
VXC27
immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids)
immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids) CDCPHINVS
36
77386006 Patient currently pregnant (finding)
pregnancy (in recipient) SCT
39
302215000 Thrombocytopenic disorder (disorder)
thrombocytopenia SCT
40
161461006 History of - purpura (situation)
thrombocytopenic purpura (history) SCT
41
Examples:
|VXC18^allergy to baker’s yeast^CDCPHINVS|
|77386006^patient currently pregnant^SCT|
Value Set Name – Vaccination Reaction - IIS
Used in OBX- 5
Value Set OID - 2.16.840.1.114222.4.11.3289
Value Set Code: PHVS_VaccinationReaction_IIS
Value set definition: indicates a reaction or adverse event associate in time with an immunization.
131
Code Set OID:
SNOMED: 2.16.840.1.113883.6.96
CDCPHINVS: 2.16.840.1.114222.4.5.274
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
39579001 Anaphylaxis (disorder) Anaphylaxis SCT
81308009 Disorder of brain (disorder)
Encephalopathy SCT
VXC9
persistent, inconsolable crying lasting > 3 hours within 48 hours of dose
persistent, inconsolable crying lasting > 3 hours within 48 hours of dose CDCPHINVS
VXC10
collapse or shock-like state within 48 hours of dose
collapse or shock-like state within 48 hours of dose CDCPHINVS
VXC11
convulsions (fits, seizures) within 72 hours of dose
convulsions (fits, seizures) within 72 hours of dose CDCPHINVS
VXC12
fever of >40.5C (105F) within 48 hours of dose
fever of >40.5C (105F) within 48 hours of dose CDCPHINVS
VXC13
Guillain-Barre syndrome (GBS) within 6 weeks of dose
Guillain-Barre syndrome (GBS) within 6 weeks of dose CDCPHINVS
VXC14 Rash within 14 days of dose
Rash within 14 days of dose CDCPHINVS
VXC15
Intussusception within 30 days of dose
Intussusception within 30 days of dose CDCPHINVS
Examples:
|39579001^anaphylaxis^SCT|
|VXC14^Rash within 14 days^CDCPHINVS|
Value Set Name – Vaccination Special Indications - IIS
Used in OBX- 5
132
Value Set OID - 2.16.840.1.114222.4.11.3290
Value Set Code:: PHVS_VaccinationSpecialIndications_IIS
Value set definition: Describes a factor about the client which may impact forecasting of next dose of vaccine needed.
Code Set OID:
CDCPHINVS: 2.16.840.1.114222.4.5.274
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value
VXC7 Rabies exposure within previous 10 days.
Rabies exposure within previous 10 days. CDCPHINVS
VXC8 Member of special group Member of special group CDCPHINVS
Example:
|VXC7^Rabies exposure^CDCPHINVS|
Value Set Name – Immunization Profile Identifiers - IIS
Used in MSH-21
Value Set OID - 2.16.840.1.114222.4.11.3291
Value Set Code: PHVS_ImmunizationProfileIdentifier_IIS
Value set definition: Identifies the profile used by the message.
Code Set OID:
CDCPHINVS: 2.16.840.1.114222.4.5.274
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value
Z31 Return Candidate Clients Return Candidate Clients CDCPHINVS
Z42 Return Immunization History
Return Immunization History CDCPHINVS
Z44
Request for an Evaluated History and Forecast
Request Evaluated History and Forecast CDCPHINVS
133
Example:
|Z44^ CDCPHINVS|
Value Set Name – Immunization Schedule Identifiers - IIS
Used in OBX-5
Value Set OID - 2.16.840.1.114222.4.11.3292
Value Set Code: PHVS_ImmunizationScheduleIdentifier_IIS
Value set definition: Identifies the schedule used for immunization evaluation and forecast.
Code Set OID:
CDCPHINVS: 2.16.840.1.114222.4.5.274
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value
VXC16 ACIP Schedule This indicates that the current ACIP Schedule of recommendations were used to forecast next doses due.
CDCPHINVS
Example:
|VXC16^ACIP Schedule^CDCPHINVS|
Local Implementations may add local codes for local schedules. In order to do this, the local implementation guide should publish the code in a local table. The code system identifier (CDCPHINVS use above is an example) needs to be included in a local copy of Table 0396. See first row for example. The local schedule code should be recorded as follows:
|yourLocalcode^your schedule name here^99xxx|
The 99xxx is the local code table identifier. xxx are alpha characters.
Value Set Name – Evidence of Immunity - IIS
Used in OBX- 5
134
Value Set OID - 2.16.840.1.114222.4.11.3293
Value Set Code: PHVS_EvidenceOfImmunity_IIS
Value set definition: Evidence of immunity indicates that a person has plausible evidence that they have already developed immunity to a particular disease. The definition of plausible evidence is a local decision, but best practice would suggest that serological evidence of immunity is the strongest indicator of immunity.
Code Set OID:
SNOMED: 2.16.840.1.113883.6.96
Concept Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
409498004 Anthrax (disorder)
History of anthrax infection. SCT
397428000 Diphtheria (disorder)
History of diphtheria infection. SCT 24
76902006 Tetanus (disorder)
History of tetanus infection. SCT 32
27836007 Pertussis (disorder)
History of pertussis infection. SCT 29
40468003 Viral hepatitis, type A (disorder)
History of Hepatitis A infection. SCT
66071002 Type B viral hepatitis (disorder)
History of Hepatitis B infection. SCT 26
91428005 Haemophilus influenza infection (disorder)
History of HIB infection. SCT 25
240532009 Human papilloma virus infection (disorder)
History of HPV infection. SCT
6142004 Influenza (disorder)
History of influenza infection. SCT
52947006 Japanese encephalitis virus disease (disorder)
History of Japanese encephalitis infection.
SCT
14189004 Measles (disorder)
History of measles infection. SCT 27
36989005 Mumps (disorder)
History of mumps infection. SCT 28
135
Concept
Code
Concept Name Definition HL7 Table 0396 Code
V 2.3.1 Value NIP004
36653000 Rubella (disorder)
History of rubella infection. SCT 31
23511006 Meningococcal infectious disease (disorder)
History of meningococcal infection.
SCT
16814004 Pneumococcal infectious disease (disorder)
History of pneumococcal infection.
SCT
398102009 Acute poliomyelitis (disorder)
History of polio infection. SCT 30
14168008 Rabies (disorder) History of rabies infection. SCT
18624000 Disease due to Rotavirus (disorder)
History of rotavirus infection. SCT
4834000 Typhoid fever (disorder)
History of typhoid infection. SCT
111852003 Vaccinia (disorder)
History of vaccinia infection. SCT
38907003 Varicella (disorder)
History of Varicella infection. SCT
16541001 Yellow fever (disorder)
History of yellow fever infection.
SCT
271511000 Hepatitis B immune (finding)
Immunity to hepatitis B SCT
QBP Guide Version History Changes
Version 1.1 Table 4 Patient Identifier Segment (PID) Sequence 10 Race HL7 Usage changed to O (optional) from RE (required but empty) Sequence 11 Patient Address HL7 Usage changed to O (optional) from RE (required but empty) Sequence 22 Ethnic Group HL7 Usage changed to O (optional) from RE (required but empty)
136
Sequence 24 Multiple Birth Indicator HL7 Usage changed to O (optional) from RE (required but empty) Sequence 25 Birth Order HL7 Usage changed to O (optional) from CE (conditional but may be empty) Sequence 29 Patient Death Date and Time HL7 Usage changed to O (optional) from RE (required but empty) Sequence 30 Patient Death Indicator HL7 Usage changed to O (optional) from CE (conditional but may be empty)
Table 9 Pharmacy Treatment Administration (RXA) (Z42) Pages 44 - 46
Sequence 4 Date Time End of Administration HL7 Usage changed to O (optional) from RE (required but empty) Sequence 6 Administered Amount HL7 Usage changed to O (optional) from R (required); MCIR usage changed to O (optional) from R (required) Sequence 7 Administered Units HL7 Usage changed to O (optional) from CE (conditional but may be empty); MCIR Usage changed to O (optional) from CE (conditional but may be empty) Sequence 9 Administered Notes HL7 Usage changed to O (optional) from RE (required but empty) Sequence 10 Administering Provider HL7 Usage changed to O (optional) from RE (required but empty) Sequence 11 Administered at Location HL7 Usage changed to O (optional) from RE (required but empty) Sequence 15 Substance Lot Number HL7 Usage changed to O (optional) from RE (required but empty) Version 1.5 Table 0-2 MSH Specification for Request Immunization History Response Sequence 5 Receiving Application MCIR Usage changed to R (required) from RE
(required but empty)
137
Sequence 15 Accept Acknowledgement Type HL7 Usage and MCIR Usage changed to R (required) from RE (required but empty)
Sequence 16 Application Acknowledgement Type HL7 Usage and MCIR Usage changed
to R (required) from RE (required but empty) Sequence 17 Country Code HL7 Usage changed to X (not supported) from O (optional) Sequence 18 Character Set HL7 Usage changed to X (not supported) from O (optional) Sequence 19 Principal Language of Message HL7 Usage changed to X (not supported)
from O (optional) Sequence 20 Alternate Character Set Handling Scheme HL7 Usage changed to X (not
supported) from O (optional) Sequence 21 Message Profile Identifier changed to Z44^CDCPHINVS Sequence 22 Sending “Response Organization HL7 Usage and MCIR Usage added new Sequence 23 Receiving Responsible Organization HL7 Usage and MCIR Usage added
new
138
Sequence 16 Substance Expiration Date HL7 Usage changed to O (optional) from RE (required but empty) Sequence 17 Substance Manufacturer Name HL7 Usage changed to O (optional) from RE (required but empty) Sequence 21 Action Code RXA HL7 Usage changed to O (optional) from RE (required but empty)
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